12441.55? 3 u z. :1. t. . .. 9...}! ‘9‘...“1 vi? 9’ p“... ‘- ‘v‘l 1" V u. .1133}: = y .92.... 5!... 5 {lunar}: 45... 5.1.. 3. alwaovbl: .L ‘ a. m NH ”9.. l3... (2...; 3.. o\ z 1.111.: .5 .91..) t1 5!. l 1. ii... 1L:5..O.v£ #:0-{3 r. . l. .1... (.65., 1335......) . V 9. . 3.13.15. .v. LIBRARY Michigan State University This is to certify that the dissertation entitled AN EXAMINATION OF THE ADVOCACY COALITION FRAMEWORK AND THE PUNCTUATED EQUILIBIRUM THEORY: A CASE STUDY OF MI PUBLIC ACT OF 2004 presented by E. JANE HAYES has been accepted towards fulfillment of the requirements for the PhD. degree in Social Work 4; g v" _ ‘ 1W a MaflProfessor’s Signature // '3 7* 0 8 Date MSU is an Affirmative Action/Equal Opportunity Employer PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. MAY BE RECALLED with earlier due date if requested. DATE DUE DATE DUE DATE DUE 5/08 Kthrolecc8-Pres/CIRCIDaleOue.indd AN EXAMINATION OF THE ADVOCACY COALITION FRAMEWORK, AND THE PUNCTUATED EQUILIBRIUM THEORY: A CASE STUDY OF MI PUBLIC ACT 61 OF 2004 By E. Jane Hayes A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Social Work 2008 ABSTRACT AN EXAMINATION OF THE ADVOCACY COALITION FRAMEWORK, AND THE PUNCTUATED EQUILIBRIUM THEORY: A CASE STUDY OF MI PUBLIC ACT 61 OF 2004 By E. Jane Hayes Policy-making is a complex process. To understand the policy change process, a qualitative case study of social work licensure, MI PA 61 Of 2004, is examined over a 14- year period (1990-2004). Two theoretical frameworks from the political science literature-advocacy coalition framework and punctuated equilibrium theory-are used to guide the research. ACF attributes the success of the legislation to the alignment and activities of the advocacy coalitions held together by shared beliefs. Punctuated equilibrium theory attributes the change to the establishment of a new policy monopoly. Interviews with a purposive sample of 21 participants representing 15 groups, organizations and public Officials in support and Opposition Of the policy provide data for the research. A document analysis of organizational and government documents along with news reports contributes to the findings of the study. A legislative history of social work licensure in Michigan from 1990-2004 is presented. A comparison of ACF and punctuated equilibrium theory using the criteria-scope of the policy making community, change in institutional structure and critical events-concludes that punctuated equilibrium theory provides a more comprehensive explanation of the passage Of MI PA 61 of 2004. The research findings support the influence Of mobilization and the establishment of a new policy monopoly on the passage of MI PA 61 of 2004. The study also provides insight into the complimentary nature of the ACF and punctuated equilibrium theory to interpret policy making. ACF provides an understanding of the role played by advocacy groups, shaped by beliefs, on mobilization; while punctuated equilibrium theory provides an understanding of the influence of mobilization on political institutions for policy change. The theoretical foundations broaden social work’s understanding of the array of variables that influence the policy change process and contribute to policy curriculum and practice. The research also provides practical guidelines for other occupations interested in achieving licensure as well as other professions committed to the development of health and social welfare policy. Copyright by E. Jane Hayes 2008 This dissertation is dedicated to my parents, Mary and Andy Fedele, and the Sisters of Charity of Greensburg, PA. My parents always encouraged their children to pursue education. The Sisters of Charity provided a liberal education and instilled a passion for learning as my teachers from grade school through college. ACKNOWLEDGMENTS I express my gratitude to Dr. Cynthia J ackson-Elmoore, Chair of my dissertation committee. Your encouragement and support are appreciated. Completing a dissertation while living and teaching in Northern Michigan provides many challenges for the chair and the candidate. The guidance you provide enables me to complete this work. I also thank the other members of my committee-Dr. Gary Anderson, Dr. Ellen Whipple, Dr. Sheryl Kubiak, and Dr. Ric Hula. I appreciate the time you invested to read and respond with comments and encouragement. Acknowledgement and appreciation are extended to Michigan State University, College of Social Sciences and the School of Social Work for the Dissertation Completion Fellowship. The fellowship provides the opportunity and support to finalize the document. I also thank my husband and dear friend, Frank. You are a constant source of encouragement and support who reminds me daily how important it is to pursue your goals. Finally, thank you to my adult children, Andy and Jessica, and my daughter-in-law, Allison. You live your lives to the fullest and inspire me each day. A blessing is extended to Justin Andrew born August 30, 2008. vi TABLE OF CONTENTS LIST OF TABLES ......................................................................... xi LIST OF FIGURES ........................................................................ xii CHAPTER 1 INTRODUCTION ......................................................................... 1 Social Work Licensure in Michigan ............................................ 1 The Political Environment ....................................................... 6 Models of Policy Making ........................................................ 7 Statement of Purpose ............................................................. 9 Research Questions ............................................................... 10 The Significance for Social Work ............................................... 11 Overview of the Dissertation .................................................... 12 CHAPTER 2 LITERATURE REVIEW ................................................................. 14 Advocacy Coalition Framework ................................................ l4 Punctuated Equilibrium Theory ................................................. 19 Comparing Models of Policy Making .......................................... 22 Comparing the ACF and Punctuated Equilibrium Models .................. 23 Interpretation 1: Advocacy Coalition Framework ................... 26 Interpretation 2: Punctuated Equilibrium Theory .................... 26 Restatement of the Research Questions ........................................ 27 CHAPTER 3 RESEARCH METHODS ................................................................. 30 Design of the Study ............................................................... 30 Selection of the Case .............................................................. 31 Participants ......................................................................... 32 Data Collection Methods ......................................................... 39 Interviews .................................................................. 39 Documents ................................................................. 42 Case Study Analysis .............................................................. 44 Summary ........................................................................... 50 vii CHAPTER 4 CASE STUDY .............................................................................. Michigan Legislative History of Social Work Licensure: 1990-2004. . Early History: 1989-1990 ............................................... History of Social Work Licensure: 1990-2004 ...................... House Bill 5004 of 1990 ................................................ House Bill 4491 of 1991 ................................................ Senate Bill 0617 of 1993 ................................................ House Bill 4813 of 1995 ................................................ House Bill 4274 of 1997 ................................................ Senate Bill 0657 Of 1999 ................................................ Senate Bill 0189 of 2003 ................................................ Summary ........................................................................... CHAPTER 5 FINDINGS ................................................................................. Scope of the Policy Making Community: MI PA 61 of 2004 .............. Groups, Organizations, and Public Officials in Support of Licensure ............................................................. Groups, Organizations, and Public Officials in Opposition of Licensure ............................................................. Changes in Institutional Structure: MI PA 61 of 2004 ...................... Alignments and Activities of Groups, Organizations and Public Officials in Support and Opposition .................................. Changes in Policy Venue ............................................... Other Critical Events: MI PA 61 of 2004 ..................................... Election of the New Governor ......................................... Bi-Partisan Support ..................................................... Legislative Day .......................................................... Social Work Summit ................................................... Public Image: MI PA 61 of 2004 .............................................. Public Safety and Welfare ............................................. Michigan as the Last State to License ................................ Free Market Protection ................................................. Restriction of Services .................................................. Job Protection ............................................................ Summary ........................................................................... viii 52 52 52 53 55 59 61 65 65 66 74 77 77 77 80 81 81 87 90 90 92 94 96 99 99 101 101 102 103 104 CHAPTER 6 CONCLUSIONS AND IMPLICATIONS ............................................. ACF: Interpretation of the Passage of MI PA 61 of 2004 ................... Scope of the Policy Making Community ............................. Institutional Structure ................................................... Critical Events ............................................................ Summary ........................................................................... Punctuated Equilibrium Theory: An Interpretation of the Passage of MI PA 61 of 2004 ............................................................. Scope of the Policy Making Community ............................. Institutional Structure ................................................... Critical Events ............................................................ Summary ........................................................................... Comparison of the ACF and Punctuated Equilibrium Theory .............. Complimentary Nature: ACF and Punctuated Equilibrium Theory ....... Social Work Implications ........................................................ Policy Practice: Value Foundation .................................... Social Work Policy Practice ........................................... Policy Practice Curriculum ............................................. Summary ........................................................................... APPENDICES .............................................................................. A. TELEPHONE/EMAIL SCRIPT ....................................... B. COVER LETTER ........................................................ C. CASE STUDY OF MI PUBLIC ACT 61 OF 2004 CONSENT FORM ..................................................................... D. LETTER OF APPROVAL FOR MSU IRB EXEMPT STUDY X05-986 ................................................................... E. INTERVIEW PROTOCOL ............................................ F. DOCUMENTS ........................................................... G. CODING AGENDA .................................................... H. MERVIEW CODING PROTOCOL ................................ 1. DOCUMENT CODING PROTOCOL ............................... J. CODE BOOK ............................................................ K. INTERVIEW MATRIX ................................................ L. DOCUMENT MATRIX ................................................ M. MICHIGAN H.B. NO. 5004 of 1990 .................................. N. MICHIGAN H.B. NO. 4491 of 1991 .................................. O. MICHIGAN SE. NO. 0617 of 1993 ................................... P. MICHIGAN H.B. NO. 4813 of 1995 ................................... Q. MICHIGAN H.B. NO. 4274 of 1997 ................................... R. MICHIGAN SE. NO. 0657 of 1999 .................................... ix 107 107 107 108 109 110 110 110 111 112 112 113 115 117 117 118 119 121 124 125 127 129 132 134 137 139 142 144 146 149 151 154 156 158 160 162 165 S. GROUPS, ORGANIZATIONS, AND PUBLIC OFFICIALS IN SUPPORT AND OPPOSITION OF SOCIAL WORK LICENSURE ............................................................... 168 REFERENCES ............................................................................... 179 LIST OF TABLES Table 1. Support for and Opposition to Michigan Senate Bill No. 0189 of 2003 ........ 5 2. Stability and Change in the ACF and Punctuated Equilibrium Theories ...... 15 3. Comparing ACF and Punctuated Equilibrium Models ........................... 24 4. ACF and Punctuated Equilibrium Theoretical Concepts and Research Questions ............................................................................... 29 5. Initial Respondents ................................................................... 34 6. Interviewees by Referrals ........................................................... 36 7. Participants: Groups, Organizations and Public Officials in Support of MI PA 61 of 2004 .................................................................... 37 8. Participants: Groups, Organizations, and Public Officials in Opposition of MI PA 61 of 2004 ................................................................. 38 9. Overview of Interview Protocol and Research Questions ...................... 41 10. Operational Definition of Variables .............................................. 45 11. Public Image of Social Work Licensure ......................................... 46 12. Coding Categories as a Framework to Collect Data Using Interview Protocol Questions .................................................................. 48 13. Language of Social Work Licensure Bills from 1990-2004 ................... 56 14. Group Alliances: Social Work Licensure from 1990-2004 .................... 57 15. States that License Social Work and Exemptions .............................. 70 16. Social Work Summit: Participants ................................................ 97 xi LIST OF FIGURES Figure 1. Michigan SB. No. 0189 of 2003 .................................................... 3 2. Historical Timeline: Michigan Legislative History of Social Work Licensure: 1990-2004 ................................................................. 54 xii CHAPTER 1 INTRODUCTION Policy-making is a complex process characterized by conflict and consensus building to achieve policy change. Policy makers compete for time, attention and resources to bring issues to the governmental agenda. Most public policy change is incremental, except for those periods when major shifts occur (Lindblom, 1959; True, 1999; 2000). The challenge to researchers is to explain how policy changes over time (Heck, 2004). Social Work Licensure in Michigan The regulation Of social work as a profession began with the passage of Article 16 of Public Act 299 of 1980 (Michigan Occupational Code). Public Act 299 was passed for the purpose of revising, consolidating, and classifying the laws of Michigan concerning occupational regulation. Article 16 created the Michigan Board of Social Work Examiners and established registration requirements for certified social workers, social workers, and social work technicians. In 1991, Governor John Engler issued Executive Reorganization Order No. 1991-91 that transferred the Michigan Board of Social Work Examiners from the Department of Licensing and Regulation to the Department of Commerce. In 2000, Public Act 11 transferred the functions and authority of the Board of Social Work from the Michigan Occupational Code to the Public Health Code, Public Act 368 of 1978. The Public Health Code required licensure of counselors and others engaged in the practice of therapy. lExecutive orders (EO) are usually identified as Executive Order No. #. However, this order is identified as Executive Reorganization Order (MCL Chapter 338, Section, 338.3501). 1 When the Board of Social Work was transferred to the Public Health Code, social workers in Michigan were registered, not licensed. Registration established both educational and work standards for the profession, but unlike licensure, required no continuing education, ethical oversight, or proficiency exam as established under the Public Health Code for all other professionals. This inconsistency provided an Opportunity for the proponents of licensure to advance the issue of social work licensing to the legislative agenda. On February 18, 2003, S. B. No. 0189 was introduced in the Michigan Senate (see Figure l). The primary sponsor of the bill was Senator Beverly Hammerstrom (R - District 17). Senators Goschka (R — District 32), Emerson (D - District 27), Clark - Coleman (D - District 3), Leland (D - District 5), and Jacobs (D - District 14) were co- sponsors of the bill. Senate Bill 0189 of 2003 required the licensing Of social workers and eliminated the inconsistency that existed with the transfer of the Board of Social Work to the Public Health Code by incorporating regulation of the profession consistent with the licensing of other counseling professionals. The goal of the legislation was to define a scope of practice to distinguish between the bachelor’s (BSW) and master’s (MSW) level. Prior to the passage of SB. 0189 of 2003, a Registered Social Worker (RSW) or Certified Social Worker (CSW) credential was the standard Of regulation for social work practice in Michigan. However, registration was not mandated in order to practice. An individual could be employed in a social work position without the RSW or CSW. Registration protected the title of social worker but did not define a scope of practice. Registration did not require ethical Figure 1 Michigan SB. No. 0189 of 2003 Short Description: SOCIAL WORK LICEN SURE Bill Number: SB0189 Senate Sponsors: Senators Hammerstrom, Goschka, Emerson, Clark-Coleman, Leland and Jacobs Synopsis as introduced: Amended the Public Health Code to include two levels of social work licensure; Defined a scope of practice for LBSW and LMSW; Required LLMSW intending to practice psychotherapy to complete a 2-year post-graduate experience under the supervision of an LMSW practicing psychotherapy; Exempted ordained clerics and social workers providing services to nonprofits; Established a 60-hour continuing education requirement. House Amendments: Revised the definition of practice for LBSW and LMSW; Directed the department to develop rules to distinguish between applications of macro and clinical social work; Exempted ordained clerics on the condition that practice was incidental to religious beliefs; Deleted requirement to file affidavit to practice psychotherapy; Required practice consistent with the code of ethics; Revised for 45 hours of continuing education over a three-year period. Bill Status/Action: Date Chamber Action 2/18/2003 Senate Referred to Committee on Health Policy 5/20/2003 Senate Reported favorably without amendment and referred to the the Committee of the Whole 7/1/2003 Senate Reported by the committee with amendment-Substitute S-1 and placed on order of third reading 7/3/2003 Senate Passed with a roll call vote-35 yeas, 2 nays, l excused Bill changed chambers (moved from the Senate to the House) 7/15/2003 House Referred to the Committee on Health Policy W3/2004 House Reported with recommendation Substitute H-4. Referred for second reading. Laid over l-day under the rules. 3/18/2004 House Substitute H-4 not adopted. Substitute H-5 adopted and amended. Placed on third reading and immediate passage. Passed-98 yeas, 8 nays. Returned to the Senate Bill changed chambers (House to Senate) 3/23/2004 Senate Laid over l-day under the rules 3/24/2004 Senate House substitute H-5 passes with immediate effect, 37 yeas, 0 nays, l excused Bill moves to Governor’s Office 3/31/2004 Governor Presented to the Governor 4/20/2004 Governor Approved by the Governor, filed with the Secretary of State and assigned PA 0061 ’04 with immediate effect. Source: Michigan Legislature (2003, Senate Bill 0189). Available: http://wwaegislaturemi.gov. Retrieved September 15, 2006. 3 oversight, continuing education or a competency exam as required for other professions regulated under the Public Health Code. Senate Bill 0189 of 2003 defined a scope of practice, and established ethical oversight, continuing education requirements, and a proficiency exam. A House amendment to SB. 189 of 2003 further defined the scope of practice by differentiating between interpersonal practice (micro) and organizational, community organizing or policy practice (macro). Advocacy groups and other stakeholders in support of SB. 0189 of 2003 (see Table 1) included such groups as the National Association Of Social Workers/Michigan Chapter, Michigan Association of Baccalaureate Social Work Educators and the Michigan Health and Hospital Association. Representatives of these associations argued for licensure to protect the public welfare and ensure quality services. Furthermore, with the passage of a social work licensure bill in Arizona in 2004, Michigan was the only state not to license social workers (Tyszkiewicz & Cole, 2003a). This was presented by proponents as a barrier to reciprocity between states for the employment of social workers. Opponents to the legislation included the MI Counseling Association, MI Association for Marriage and Family Therapy and United Auto Workers (Stutzky, 2004). Representatives of these associations argued against the legislation citing concerns regarding the licensure of the bachelor level social worker as well as the scope of practice for the master level social worker. Furthermore, it was their opinion that increased costs to the Department of Consumer and Industry Services would occur with the need for additional staff to provide monitoring of the application process and continuing education requirements. The bill proposed no additional revenue to cover the costs that were estimated to be approximately $90,000 (Tyszkiewicz, 2003). Opponents also argued that the bill did not contain an exemption for the Family Independence Agency2 employees who were not degreed but worked in social work roles for a number of years. Requiring social work degrees for these workers would result in increased case loads, management responsibilities and employee turn over for the agency, according to those who opposed the bill (Layman & Tyszkiewicz, 2003; Tyszkiewicz & Cole, 2003b). Table 1 Support for and Opposition to Michigan Senate Bill No. 0189 of 2003 Supporters Opposition 0 Michigan Association of BSW Educators 0 Michigan Federation for Children and Families 0 National Association of Social Workers (NASW)/Michigan Chapter 0 Michigan Association of School Social Workers 0 Michigan Health and Hospital Association 0 Michigan Association of Community Mental Health Boards 0 Michigan County Social Services Association 0 Michigan State University School Of Social Work Michigan Catholic Conference Michigan Association of Counties Michigan Department Of Community Health Source: Stutzky (2004). American Mental Health Counselors Michigan Association for Adult Development and Aging American Association for Marriage and Family Therapy Michigan Association of Humanistic Education Michigan Mental Health Counselors Association Economic Alliance United Auto Workers 2Renamed the Department of Human Services during Granholm Administration. Substitute SB. 0189 passed in the Senate on July 3, 2003 and was referred to the House. The bill amended Part 185 (Social Work) of the Public Health Code and required licensing for social workers one year after the bill’s effective date. The bill defined a scope of practice for the BSW and MSW, required a MSW intending to practice psychotherapy to complete a two-year post-graduate experience under the supervision of an LMSW practicing psychotherapy, exempted ordained clerics and social workers providing services to nonprofits, and established a 60-hour continuing education requirement. Following deliberations in the House, a substitute for S. B. N o. 0189 was passed on March 18, 2004. This substitute (H-5) revised the scope of practice for the BSW and MSW, deleted the requirement of a two-year post graduate experience for those practicing psychotherapy, exempted ordained clerics on the condition that practice was incidental to religious beliefs, and required practice consistent with the code of ethics. Furthermore, it revised the 60-hour continuing education requirement to 45-hours over a three-year period. The House substitute was referred back to the Senate and approved by the Senate on March 24, 2004. On April 12, 2004, SB. 0189 of 2003 was signed into law by the Democratic Governor Jennifer Granholm and became MI Public Act 61 of 2004 (Hettiger, 2004; Layman, Angelotto & Cole, 2004). The law was implemented on July 1, 2005 (Hayes, 2005). The Political Environment Social work licensing surfaced on the political agenda several times during the 19903 prior to its passage in 2004. During the 1990 gubernatorial election, then Governor, Jim Blanchard, with a Democratic controlled House and a Republican controlled Senate agreed to sign a social work licensing bill if re-elected (in-person interview, organization in support, September 10, 2007).3 However, Blanchard lost the election to John Engler, the Republican candidate and a long time member of the Michigan Legislature. Engler Opposed any form of occupational regulation (John Engler, personal communication, October 16, 1991).4 This position was consistent with a conservative ideology that government regulation of any kind infringed on a free economy and on the individual right of the citizen to choose commodities or services (George & Wilding, 1993). As a result, the bill for social work licensure reached a policy impasse and remained in this condition until the gubernatorial election of 2002. In the spring of 2002, the Democratic candidate for Governor, Jennifer Granholm, announced her candidacy at the Michigan-National Association of Social Workers’ Legislative Day and pledged to sign a social work licensure bill. In February 2003, Senator Beverly Hammerstrom. introduced SB. 0189 in the Michigan Senate. Models of Policy Making An examination of the historical development of MI PA 61 of 2004 over this period provides an opportunity to investigate the applicability of the advocacy coalition framework and punctuated equilibrium theory to explain the policy change process, relative to social work licensure in the state of Michigan. These models are intended to provide a conceptual map to guide the understanding of a complex process (Mintrom & Vergari, 1996). According to Sato (1999), a model provides a framework within which to understand the policy process and allows for consideration of how theories may complement one another. These models are consistent in their discussion of both stability 3Interview quote included in Chapter 4, Findings. 4See Appendix F, Documents. Document quote included in Chapter 4, Findings. 7 and change as components of the policy change process. However, they differ in their emphasis on a particular facet of policy making-stability or change. According to Mintrom and Vergari, studying how two models complement one another can be useful to advance understanding of the policy change process. The goals of this dissertation are to understand the nature of the policy change process by examining a policy event-MI PA 610f 2004, and to examine how these two theoretical models may complement one another. The advocacy coalition framework (ACF) explains periods of stability and incremental change (Sabatier & J enkins-Smith, 1993). According to the ACF, the alignment and activity of policy elites (interest groups and policy actors) translates belief systems into policy and maintains the policy over time. Punctuated equilibrium theory suggests that periods of stability, maintained by policy monopolies, are punctuated by dynamic change as a consequence of public mobilization (Baumgartner & Jones, 1993). These theories are chosen for this study because they are well articulated, empirically tested, and are consistent in their discussion of stability and change (Breton, Richard, Gagnon, Jacques & Bergeron, 2006; Houlihan & Green, 2006; Kuebler, 2007; Larsen, Vrangbaek, & Traulsen 2006; Mortensen, 2007; Nagel, 2006; Schrad, 2007; Weible, 2006; Wood, 2006; Worsham, 2006). The ACF, as a framework of stability and incremental change, suggests that the passage of MI PA 61 is the result of the alignment and activities of the advocacy coalitions over a l4-year period.5 While punctuated equilibrium, as a theory of dynamic 5The Dissertation Proposal indicated a lO-year timeframe for examination (l994-2004). A decision was made during data collection to study the history of social work licensure over a 14-year period (1990- 1994). This decision was made to incorporate documents for analysis from the early years of the Engler Administration. change, suggests that the passage of the policy is a result of stakeholder mobilization and the establishment of a new policy monopoly. The two frameworks offer alternative explanations of the same policy event. Also, combined insights from ACF and punctuated equilibrium theory provide an understanding of how a variety of political forces produces policy change (Mintrom & Vergari, 1996; Sobeck, 2003). Statement of Purpose The purpose of this dissertation was to expand the knowledge base of social work to incorporate a fuller understanding of the policy change process. TO achieve this purpose, the advocacy coalition framework (Sabatier & Jenkins-Smith, 1993) and punctuated equilibrium theory (Baumgartner & Jones, 1993) were examined, as outlined in the political science literature. A case study of Michigan Public Act 61 2004, that regulated the practice of social work, was used to analyze the policy change process during a 14-year period (1990-2004). From 1990 until 2004, a policy impasse existed regarding the licensing of social workers in the state of Michigan. Policy change occurred with the passage of MI PA 61 in 2004. The period (1990-2004) prior to the passage of MI PA 61 2004 met the criteria for the study of the policy change process over a decade or more (Baumgartner & Jones, 2002; Sabatier, 1999; True, 2000). This time frame included periods of stability and change and provided a history for examining the influence of advocacy coalitions and public mobilization on major policy shifts. It is this 14-year period that was examined to determine the effects of advocacy coalitions and public mobilization on policy change. Interviews with policy actors provided data for the study. A document analysis of news reports, organizational and government documents (e. g. state legislative committee meetings, fiscal and legislative analysis, roll call data) was also completed. Research Questions The primary research question that emerged from a historical consideration of the passage of MI PA 61 of 2004 was the following: What changes occurred in the political environment during this 14-year period that influenced the passage of MI PA 61 of 2004? (a) How did the election of a new governor, Jennifer Granholm, influence passage of the policy? (b) How did the alignment and the activities of the organizations in support and opposition influence the policy-makers over this l4-year period? (c) What changes may have occurred in the alignment and relationships of the organizations in support and opposition over this 14-year period? (d) How did the policy monopolies influence policy-makers over this l4-year penod? (e) What changes may have occurred to establish new policy monopolies to influence passage of the policy? (f) How did critical events and other factors influence the passage of MI PA 61 of 2004? 10 The Significance for Social Work Michigan contained approximately 10,400 registered social workers and 13,000 certified social workers when the social work licensure bill passed in 2004 (Hayes, 2005). Occupational regulation established minimum standards for entry into a profession in order to protect the public as well as to identify the profession as the sole provider of a service (Biggerstaff, 2000; Carroll & Gaston, 1986; Cohen & Deri, 1992; Leland, 1979). Arguments for social work licensure in Michigan were introduced claiming to protect the welfare of the public. According to this theoretical (orientation, the public interest was protected through the establishment of qualifications regarding who was granted access to the profession. It is assumed that occupational regulation provides a standard by which to judge competent practice and, thus, Offers a higher quality of service (Carroll & Gatson, 1986). These statutes usually “declare who is allowed to use the title social worker, establish an examination board, set continuing education policies, and outline disciplinary hearing procedures” (Dyeson, 2004, p. 408). Licensing is also considered a vehicle for increasing the status and income of the profession (Moore, 1961). This perspective suggests that the regulation of any profession is in response to the demands of professional interest groups. The intent of these interest groups is to restrict the practice of the profession for the purpose of increasing status and income. According to this view, credentialing is a restraint of trade and intends to ensure autonomy of practice and acknowledgement of the profession as the sole provider of the service (Biggerstaff, 2000). 11 According to Adam, Ekelund, and Jackson (2003), occupational regulation decreases the amount of services provided, increasing the demand. It is assumed that the decrease in service is a cost of quality assurance according to those who advocate for regulation as protection of the public. For those that consider regulation a vehicle for advancing self interest, this decrease in services increases demand while access to the profession is restricted, thus, increasing the income and status of the practitioners (Maurizi, 1974). The issue of licensing may create a paradox for the social work profession. If licensing restricts access to the profession and contributes to a decrease of services, is this not in contradiction with its values to provide access to services for populations in need? This dissertation is not intended to examine this question. However, it is acknowledged that the contradiction may exist and the intent of licensure incorporates both concern for the public and the self interests of the profession. Overview of the Dissertation This dissertation is organized into six chapters. Chapter One includes: social work licensure in Michigan; the political environment; models of policy making; statement of purpose; research questions; significance for social work; and overview of the dissertation. Chapter Two includes: literature review on the ACF; literature review on punctuated equilibrium theory; literature review on comparing models of policy making; a comparison and interpretation of the ACF and punctuated equilibrium theory relevant to MI PA 61 of 2004; and restatement of the research questions. Chapter Three includes: research methods; design of the study; selection of the case; participants; data collection methods; case study analysis; and, summary. Chapter Four includes: case study of the 12 Michigan legislative history of social work licensure: 1990-2004; early history: 1989- 1990; House Bill NO. 5004 of 1990; House Bill NO. 4491 of 1991; Senate Bill No. 0617 of 1993; House Bill NO. 4813 of 1995; House Bill No. 4274 of 1997; Senate Bill NO. 0657 of 1999; Senate Bill NO. 0189 of 2003; and, summary. Chapter Five includes: findings: scope of the policy making community; changes in institutional structure; other critical events: MI PA 61 of 2004; public image: MI PA 61 of 2004; and, summary. Chapter Six includes: conclusions and implications; ACF: interpretation of the passage Of MI PA 61 of 2004; summary; punctuated equilibrium theory: an interpretation of the passage of MI PA 61 of 2004; summary; comparison of the ACF and punctuated equilibrium theory; complementary nature: ACF and punctuated equilibrium theory; social work implications; and, summary. 13 CHAPTER 2 LITERATURE REVIEW Advocacy Coalition Framework The advocacy coalition framework (ACF) is presented as a model of policy stability for its discussion of policy learning and the influence of advocacy coalitions and belief systems on the policymaking process (Sabatier & Jenkins-Smith, 1993). According to Heclo (1974), policy change is an outcome of both macro conditions and the interaction of policy experts (policy elites) within specific policy areas who compete for power and policy effect over time. According to the ACF, policy oriented learning occurs over a decade or more (Breton et al., 2006; Elliot & Schlaepfer, 2001; Gilad, 2003; Kiibler, 2001; Kuebler, 2007; Larsen et al., 2006; Menno & Pieter-J an, 2001;Nage1, 2006; Schom, 2005; Sobeck, 2003; Weible, 2005; 2006; Weible & Sabatier, 2005). It is the interaction of the policy elites during this period that influences change in belief systems that produces incremental policy change within a policy subsystem (see Table 2). A policy subsystem is the “interaction of actors from different institutions who follow and seek to influence governmental decisions in a policy area” (Sabatier & Jenkins-Smith, 1993, p. 16). The basic strategy of the advocacy coalition framework is to use the structure of belief systems (core and secondary beliefs) to predict how changes in the belief system over time produce policy changes in a policy subsystem. Weible and Sabatier (2005), in their research on the California Marine Protected Area policy, affirm the basic concept of the model in determining that shared beliefs are the best predictor for the policy network relationships that influence policy change. 14 Table 2 Stability and Change in the ACF and Punctuated Equilibrium Theories ACF Punctuated Equilibrium Stability Policy Learning Policy Monopolies Belief systems of advocacy Political institutions and policy coalitions venues with control over the policy image Change Macro-Conditions Mobilization Changes in governing coalitions Change in policy venue Policy decisions in other sub- Redefining and expansion of the systems policy image across systems Socioeconomic conditions Establishment of new policy monopolies According to Sabatier and Jenkins-Smith (1993), advocacy coalitions consist “. . .of actors from a variety of public and private institutions at all levels of government who share a set of basic beliefs (policy goals plus causal and other perceptions) and who seek to manipulate the rules, budgets, and personnel of governmental institutions in order to achieve these goals over time” (p. 5). These belief systems are the value priorities of a policy subsystem. The policy subsystem includes actors from all levels of government along with lobbyists, advocates, and representatives of other organizations involved with policy development and implementation. The belief system of the policy subsystem consists of core beliefs and secondary beliefs. It is the core beliefs that sustain and maintain the policy direction of the 15 subsystem over time (Zafonte & Sabatier, 2004). These belief systems include self- interests, organizational and professional interests, and socialization. The belief systems motivate advocates of the policy subsystem to attain public policies that reflect their core beliefs. Certainly, the policy subsystem is dependent upon its social, political and economic resources to maintain itself, but it is the core beliefs of the policy subsystem that sustain the public policy that serves the interests of the subsystem. Sabatier and J enkins-Smith (1993) propose that public policies incorporate the belief systems of the policy subsystem. Thus, changes in public policy can be mapped over time to assess the influence of actors and their belief systems on policy change. ACF maintains that major policy shifts occur when the policy subsystem is altered by macro changes in governing coalitions and socio-economic conditions. A strength of the ACF, as a model of policy stability, is its attention to the alignments and activities of groups as to their influence on policy development. According to Sabatier and Jenkins—Smith (1993) and Zafonte and Sabatier (2004), these coalitions remain stable over a decade or more. Also, ACF emphasizes the significance of beliefs not only to define the policy issue in support or opposition but to solidify and motivate the advocacy coalitions to work over time to achieve the policy. Breton et al. (2006) and Larsen et al. (2006) applied ACF to analyze the influence of these group alliances and belief systems on policy change. Breton et al determined that the application of the ACF was useful to understand the changes in tobacco policy that occurred in Quebec during the 19903. 16 In their research, Breton et al. (2006) identified two competing coalitions that sought to influence tobacco policy. These coalitions remained stable in their alignments over the decade. The pro-tobacco coalition consisted of tobacco manufacturers and small retailers. These groups organized and defined the tobacco issue as a contraband problem. According to the pro-tobacco coalition, the contraband problem was to be resolved by lowering the tobacco tax in order to reduce the smuggling of lower price tobacco from the United States to Canada. The coalition was well funded and established a broad array of actors that included the more influential representatives of Parliament. The competing coalition of anti-tobacco activists had neither the structure nor sufficient resources to influence government. Larsen et al. (2006) also applied the ACF to explain the deregulation of the distribution of medicine in Denmark for its attention to ideology as a factor influencing policy change. In this case, two coalitions aligned over a decade to influence policy makers. The public control coalition was organized to maintain state control over privately owned pharmacies’ distribution of medicines; while, the market mechanism coalition sought to deregulate such distribution. A compromise was achieved that limited deregulation of the pharmacy sector allowing the sale of over the counter medicines through supermarkets and gas stations. Larsen et al. (2006) concluded that the ideological considerations of the ACF did contribute to an examination Of this particular case of policy change. A weakness of ACF is its limited articulation of the conditions that produce dynamic change. According to Sabatier and Jenkins-Smith (1993), dynamic change is the result of: “changes in socio economic conditions; changes in a systemic governing l7 coalition; and, policy decisions and impacts from other subsystems” (p. 18). Also, ACF assumes that the alignment and activities of the advocacy groups solidified by their beliefs produce coordinated activity-mobilization (Schlager, 1995 in Kiibler, 2001). Kiibler (2001) used the ACF as a framework for understanding the policy change process related to changes in Switzerland’s drug policy over a 20-year period to critique this assumption. Kiibler addressed the role of collective action-mobilizing and political Opportunity structures-on policy change and coupled ACF with social movement theory as a theoretical lens to explain changes in Switzerland’s drug policy. Kiibler (2001) concluded that it was not only the belief systems of the coalitions and exogenous shock that brought change, but also the mobilizing structures and political opportunities that appeared important for the formation and endurance of the advocacy coalitions. Kiibler argued that the ACF coupled with social movement theory provided a better explanation of how the activity of advocacy coalitions influenced policy change in the case of Switzerland’s drug policy. The ACF emphasizes the influence of policy elites, belief systems (ideas and ideology) and alignments and activities of interest groups over a decade or more to explain incremental policy change. However, the framework is less specific in regard to examining the conditions that may influence major shifts in policy (Mintrom & Vergari, 1996). Also, the model provides no discussion of the influence of public mobilization on major policy change (Kiibler, 2001; Schlager, 1995). Punctuated equilibrium theory addresses the conditions for dynamic policy change and the influence of mobilization during periods of major policy shifts (True, Jones, & Baumgartner, 2006). 18 Punctuated Equilibrium Theory Punctuated equilibrium theory proposes that the policy process is driven by periods of stability that are punctuated by major policy shifts (Baumgartner & Jones, 1993; Breunig & Koski, 2006; Davis, 2006; Give], 2006; Houlihan & Green, 2006; Jones & Baumgartner, 2004; Jones, Baumgartner & True, 1998; Mortensen, 2007; Schrad, 2007; Wood, 2006; Worsham, 1998, 2006). Incremental change occurs during periods of stability. Dynamic change occurs when the public mobilizes for a change in a policy monopoly (policy venue and policy image). A policy monopoly is an institutional structure with decision-making authority associated through “prevalent understandings of the policy [that] are so positive that they evoke only support or indifference by those not involved” (Baumgartner & Jones, 1993, p. 7). The policy venue is the “institutional location where authoritative decisions are made concerning a given issue” (p. 32). The policy image is the public understanding of the issue. During periods of stability, equilibrium is maintained as a result of the diminishing return in the form of policy change to the inputs of the institutions. This is referred to as negative feedback. It is negative feedback that maintains the bureaucratic behavior of institutions thus allowing for incremental change and acting as a barrier to policy shifts. According to Baumgartner and Jones (1993, 2002), major policy change occurs with positive feedback producing disequilibrium. Major policy shifts are characterized by the presence of certain conditions. These include: (a) the mobilization of the public to overcome resistance from the status quo; (b) the establishment of new policy venues; and (c) the expansion of the policy image across systems. 19 Punctuated equilibrium is a well developed theory of policy change that provides concepts for understanding both periods of stability and change (see Table 2). Also, the theory provides an understanding of the influence of mobilization on institutional and policy change. However, it is less defined in its articulation of the role and influence of advocacy groups on the policy process (Davis, 2006; Give], 2006; Worsham, 1998). Punctuated equilibrium theory assumes that interests groups are participants within the policy subsystem mobilizing for institutional and policy change. A number of researchers applied punctuated equilibrium theory to examine the nature of the policy change process. Breuning and Koski (2006) examined state budgets over an 18-year period across 50 states for evidence of punctuated equilibrium theory. The research was intended to extend an analysis of punctuated equilibrium theory to the state budget policy process. Findings confirmed that the state budget process consistently produced punctuated policy outcomes and supported the logic of punctuated equilibrium theory that periods of stability are interrupted by punctuations. Givel (2006) examined tobacco policy changes over a l3-year period (1990 to 2003) that included the Global Tobacco Settlement of 1998 to determine if changes could be explained by punctuated equilibrium theory. The research examined whether the pro- tobacco monopoly was maintained over this time frame, while challenged by the mobilization and activism of health advocates. Findings indicated that the tobacco industry6 remained stable throughout the period. However, according to Givel, the Global Tax Settlement of 1998 fell short of a punctuation defined as a “sharp and short-term 6Policy monopoly composed of prominent Congressional leaders in key positions, Department of Agriculture, farmers, agribusiness, and corporate entities. 20 exogenous shock (p. 405) that significantly altered institutional arrangements within the system. Worsham (2006) challenged the position of Givel (2006) that the Global Tobacco Settlement of 1998 fell short of a punctuation, but considered it to be an indicator of positive feedback and a punctuating moment. In his research, Worsham mapped changes in policy within the tobacco policy subsystem between 1945 and 2005. Punctuated equilibrium theory provided the foundation for demonstrating how punctuations may occur as an opportunity for change presented itself during a period of relative stability. According to Worsham (2006), positive feedback occurred as a competing coalition to the dominant coalition Of the tobacco interests shifted attention to a neglected side of the tobacco issue-disease. The author concluded that during the last half of the 20th century, these dominant and competing coalitions altered subsystem arrangements beginning with the Surgeon General’s Report on Smoking and Health of 1964 and continued with the Global Tobacco Settlement of 1998. Therefore, both were considered punctuations. Davis (2006) also researched policy change over a 20-year period related to the wildfire suppression program administered by the United States Forest Service under the Department of Interior. Davis’ research focused on policy image and venue shopping as key influences on policy change. Davis concluded that a “configuration of events, media attention, issue-redefinition” (p. 125) resulted in a shift in venue that ultimately reduced the autonomy of the United States Forest Service as public land managers. Davis also critiqued punctuated equilibrium theory as less developed in indentifying the coalitional foundations of policy change when compared to ACF. 21 In summary, punctuated equilibrium theorizes that stability is the result of policy monopolies (institutions and venues) controlling the policy image (public understanding of the issue). Policy change occurs when stakeholders mobilize against the status quo, the policy venue changes, the policy image is redefined and expanded across systems, and a new policy monopoly is established. However, punctuated equilibrium theory is less defined in its articulation of the role and influence of advocacy groups on policy change. Comparing Models of Policy Making There are a number of researchers who have examined the complementary nature of models to better understand the nature of the policy change process. Mintrom and Vergari (1996) concluded from their research on education policy reform in Michigan that there was a high degree of compatibility between the ACF and Policy Entrepreneurship Model. The ACF and Policy Entrepreneurship Model were compared and contrasted according to the following criteria: (a) scope of the policy making community; (b) relevant time-frame; (c) degree of structure in the policymaking process; and (d) origin of crisis events. According to the Mintrom and Vergari, the ACF would benefit by including insights from the Policy Entrepreneurship Model. Sato (1999) examined smoking control policy change in Japan through the lens of the ACF and the Policy Process Analysis Model (PPA). The models were compared and contrasted for their similarities and differences so that one might augment the other. According to the ACF, the changes in tobacco policy were the result of the competing belief systems of the pro-tobacco and anti-tobacco coalitions. The PPA described and examined a set of processes significant to policy development-how the issue developed, 22 how the agenda was set, how choices were made, and how alternative solutions were implemented. Sato concluded that the ACF provided a concise and simplified model for the analysis of competing coalitions, but would benefit from consideration of the process of policymaking as proposed by the PPA. Houlihan and Green (2006) analyzed the inclusion of School Sport and Physical Education policy into the National Curriculum in England and Wales over a 15—year period. Houlihan and Green compared two models of the policy change process-ACF and Multiple Streams (MS)-to explain the policy event. Findings indicated limited support for the ACF as an explanation for the policy reform. Houlihan and Green concluded that MS provided a more plausible explanation for the policy decision. ACF attributes policy change to the alignment and activity of groups. While, punctuated equilibrium theory attributes policy change to public mobilization establishing a new policy monopoly. ACF and punctuated equilibrium theory are compared to determine if one may augment the other to broaden understanding of the policy change process. Comparing the ACF and Punctuated Equilibrium Models The ACF and punctuated equilibrium theory are compared to determine the complementary nature of the models to better understand how an array of political forces may influence the policy change process. It is suggested by the researcher that the ACF may benefit by including insights from punctuated equilibrium theory related to expanding the policy making community beyond policy elites to public mobilization; while, punctuated equilibrium may benefit from a greater consideration of the influence of interest groups over a decade or more. The frameworks are compared using the criteria 23 formulated by Mintrom and Vergari (1996) concerning: (a) scope of the policymaking community, (b) time-frame, (0) degree of structure in the policy making process, and (d) origins of crisis events (see Table 3). Table 3 Comparing ACF and Punctuated Equilibrium Models ACF Punctuated Equilibrium Scope Policy elites and advocacy Policy monopolies and public coalitions mobilization Ti me-Frame Decade+ Decade+ Structure Fixed institutional arrangements Flexible institutional arrangements Crisis Events External to the policy subsystem Internal and external to the policy subsystem Within the ACF, the scope of the community is conceptualized as narrow with policy elites interacting with one another to affect the change reflective of their beliefs. In contrast, punctuated equilibrium theory broadens the policymakin g community beyond the activity of policy elites to a wider audience across a variety of venues. The expansion of the policy image across systems expands the process to include the public and the mobilization of groups usually without power within the policymaking process (Davis, 2006; Heck, 2004). These venues include but are not limited to the media, courts and other political institutions. Both the ACF and punctuated equilibrium theory suggest that to analyze policy change, a historical perspective of a policy subsystem over a decade or more is necessary. The advocacy coalition framework is a model of stability and incremental change (Breton et al., 2006; Mintrom & Vergari, 1996); while, punctuated equilibrium theory is a model 24 of stability and dynamic change (Baumgartner & Jones, 1993). A decade or more provides a time-frame to make sense of both stability and change (Givel, 2006; Sabatier & Jenkins-Smith, 1993). The ACF and punctuated equilibrium theories assume a formality in structure and process in policy making. Both are descriptive of a facet of policymaking-stability and change. However, the ACF views institutional arrangements as fixed (Mintrom & Vergari, 1996). According to Sabatier and Jenkins-Smith (1993), advocacy coalitions generally remain stable over a decade or more in their efforts to influence the policymakers. It is the core beliefs of the policy elites that maintain the coalitions. On the other hand, punctuated equilibrium theory views institutional arrangements as flexible. Such change can occur as the public mobilizes, the venues change, the policy image expands, and new policy monopolies are established (Givel, 2006). The ACF suggests that crisis events are external to the policy subsystem. According to the ACF, conflict within the system is minimized by policy brokers working to develop a consensus. Thus, a crisis is less likely to develop from within the policy subsystem (Heck, 2004; Mintrom & Vergari, 1996). According to punctuated equilibrium theory, conflict is minimized by policy monopolies within the policy subsystem during periods of stability. However, during periods of dynamic change, public mobilization and expansion of the policy image across systems create conflict and crises that are internal and external to the policy subsystem (Davis, 2006; Givel, 2006; Houlihan & Green, 2006). An interpretation of the application of each model to the policy event of MI PA 6lof 2004 is provided. The interpretations are guided by the distinctions between the 25 frameworks regarding the scope of the policy making community, the structure of the policy change process, and other critical events. Interpretation 1: Advocacy Coalition Framework According to the ACF, the key actors involved in the passage of MI PA Act 61 of 2004 included representatives of social work professional associations committed to the advancement of profession, associations committed to the delivery of public and private services, representatives of higher education, and representatives of government. Key actors in opposition to the regulation included professional associations of other helping professions, labor unions and business organizations (see Table 1). The ACF proposes that the policy elites of these advocacy organizations remained stable in their support or opposition of the regulation between 1990 and 2004. Over this l4-year period, the key actors in support worked with the policy makers for change resulting in the passage of MI PA 61 of 2004. According to ACF, it was beliefs and efforts of the policy elites over this period that brought change-policy learning. Also, the ACF suggests that there was an external system event in the form of a change in governing coalition that influenced passage of the legislation. This change in governance is identified as the election of a new Governor, Jennifer Granholm. Interpretation 2: Punctuated Equilibrium Theory Punctuated equilibrium theory broadens the scope of the policy making community to include, both the political institutions in the form of policy monopolies as well as public mobilization. According to punctuated equilibrium theory, stakeholder mobilization is a major influence for dynamic policy change. As mobilization occurs, 26 venues change and the policy image expands across systems. Significant events occur to increase conflict internal and external to the policy subsystem. In the case of MI PA 61 of 2004, two significant events were identified. The first is the passage of MI PA 11 Of 2000 that transferred the Board of Social Work Examiners from the MI Occupational Code to the MI Public Heath Act. This change in venue provided an opportunity to redefine the licensing issue and move it to the legislative agenda (expansion of policy image across systems). The second significant event was the election of Governor Jennifer Granholm, who pledged support for licensing in her campaign, and was endorsed by MI-National Association of Social Workers-Political Action for Candidate Election. Restatement of the Research Questions For this research, the ACF and punctuated equilibrium theory were used as a foundation to explain a policy event. According to the ACF, it was the beliefs and effects of the advocacy groups coupled with the election of a new governor that influenced the passage of MI PA 610f 2004. While, punctuated equilibrium theory suggested that mobilization of stakeholders, the transfer of the Michigan Board of Social Work Examiners from the Michigan Occupational Code to the Public Health Code and the election of a new governor influenced passage. To answer the primary research question as to what changes occurred in the political context to influence the passage of MI PA 61 of 2004, the following questions were asked (see Table 4): 1. How did the election of the new governor, Jennifer Granholm, influence passage of the law? 27 2. How did the alignment and activities of organizations in support and opposition influence the policy-makers over this 14-year period? 3. What changes occurred in the alignment and relationships of the organizations in support and opposition over this 14-year period? 4. How did policy monopolies influence policymakers over this 14—year period? 5. What changes occurred to establish new policy monopolies to influence the passage of the policy? a. How were stakeholders mobilized to influence policy change? b. How did the transfer of the Michigan Board of Social Work Examiners from the Michigan Occupational Code to the Public Health Code influence the passage of MI PA 61 of 2004? c. How did the public understanding of the licensing issue influence policy development? 6. How did critical events or other factors influence the passage of the MI PA 61 of 2004? 28 Table 4 ACF and Punctuated Equilibrium Theoretical Concepts and Research Questions Stability Change ACF 2. How did the alignment and activities of the competing organizations influence policy-makers? 3. What changes occurred in the alignment and relationships of the organizations? 1. How did the election of a new governor influence passage of the law? 6. How did critical events and other factors influence the passage of the law? Punctuated Equilibrium 4. How did policy monopolies influence policy-makers? 5. What changes occurred to establish new policy monopolies to influence passage of the policy? (a) How were stakeholders mobilized to influence policy change? (b) How did the transfer of the Michigan Board of Social Work Examiners from the Michigan Occupational Code to the Public Health Code influence the passage of MI PA 61? (c) How did the public understanding of the licensing issue influence policy development? 6. How did critical events or other factors influence passage of the law? Note: Table 5 maps the research questions onto the concepts of stability and change as presented in ACF and punctuated equilibrium theory (see Table 2). 29 CHAPTER 3 RESEARCH METHODS Design of the Study This dissertation is a case study of MI PA 61 of 2004, Social Work Licensure. A case study is defined as an in-depth examination of a single case with consideration given to environmental context (Brandell & Varkas, 2001). Sabatier (1988), Sabatier and Jenkins-Smith (1993), and Kingdon (1995) make use of this particular method in their research on the policy change process as do a number of other researchers (Gilad, 2003; Hula, Jackson, & Orr, 1997; Hula & J ackson-Elmoore, 2001; Schom, 2005; Sobeck 2003; True, 1999; Weible & Sabatier, 2005; Yin, 1993). A qualitative methodology is utilized for the research. The qualitative method is well suited for research that examines the policy change process and has been used across a variety of social science disciplines (Creswell, 1998; 2003; Grinnell, 2007; Marshall & Rossman, 1999; O’Sullivan, Rassel & Bemer, 2003). Grinnell distinguishes qualitative from quantitative research according to the characteristics common to qualitative studies: 0 Studies carried out in the setting where participants live or work. 0 Studies where variables cannot be controlled to observe their effect. 0 Studies in which data collection is influenced by the experiences of the participants rather than standardized instruments of measurement. 0 Studies in which interpretations are drawn from the data. A qualitative design applies a process that includes data organization, theme development, interpretation, and report writing (Marshall & Rossman, 1999). To assist with the identification and development of themes, this research makes use of 30 predetermined categories and an a priori coding strategy to allow for an interpretation that incorporates an analysis as to the application of ACF and punctuated equilibrium theory to explain the passage of MI PA 61 of 2004. Both numeric and text analysis are used to interpret and represent the data from interviews and documents (Creswell, 2003). This chapter presents a rationale for the selection of MI PA 61 of 2004 as the case study. It also provides a description of the methods used for data collection and data analysis to examine the two theoretical frameworks-advocacy coalition framework and punctuated equilibrium theory-for their interpretation of the passage of MI PA 61 of 2004. Selection of the Case The ACF and punctuated equilibrium theory are frameworks applied to describe policy change at both the state and federal levels of government. Devolution policy of the last 28-years has shifted policy making from the federal to the state level (Gronbjerg & Solomon, 2002). Therefore, it is assumed that the application of the ACF and punctuated equilibrium theory to interpret the passage of a policy would inform those involved in policy making to the process of policy change at the state level. Both the ACF and punctuated equilibrium theory propose that research on the policy change process requires a policy subsystem studied over a decade or more. MI PA 61 of 2004 is identified as the case for this research in that it represents such a subsystem- occupational regulation. The policy also has a history that extends over a 30-year period (MI-National Association of Social Workers, 2005). This history provides the foundation for an in-depth examination that allows for consideration of the groups and organizations involved and the critical events that may have influenced passage. Thus, MI PA 61 of 31 2004 meets the criteria for study when applying the theoretical foundations of the ACF and punctuated equilibrium theory and allows for an interpretation that considers the environmental context. This case is also relevant to the social work profession. The choice of a case significant to the practice of social work in the state of Michigan provides a focus for an interpretation as to the influence of the profession on the passage of the legislation. As a recent case, its history allows for a review of the knowledge and political skill of the profession and an assessment of the profession’s role in the passage of the legislation for its relevancy to social work policy practice. Furthermore, it is acknowledged that the researcher is a licensed social worker in the state of Michigan and familiar with the history of the legislation as well as groups and organizations involved in its passage. In addition, the researcher is a former past president of both the Traverse City Public School Board (1992-1996) and the Great Lakes Community Mental Health Board (1996-2002), and a former candidate for the Michigan House of Representatives. This background contributes to an interest in state and local policy making and the theoretical frameworks that explain the policy change process. Participants The intent of this research was to explore the relationships and activities of groups and organizations in support and opposition of social work licensure over a 14-year period as well as the critical events that influenced passage of MI PA 61 of 2004. To identify potential participants, a list of organizations and their representatives was compiled from the public record. The documents to identify participants were accessed 32 through a search of the Michigan Legislature Website (http://www.legislaturemigov). The public record included documents that recorded the organizations in support and opposition of the legislation. These individuals and organizations represented the following categories: 1. Individuals and groups in support of social work licensure 2. Individuals and groups in opposition of social work licensure 3. Public officials (elected, appointed, and employed) Ten organizations and their representatives were identified from the public record as in support of the SB. 0189 of 2003. Seven organizations and their representatives were identified as in opposition. Five public officials (elected, appointed, and employed) were identified from the public record or targeted by reputation for their support, while four were identified for their opposition. Twenty-seven initial contacts were made. Contacts with multiple representatives of an organization were made with three organizations to access both the breath and depth of historical and current information related to the passage of MI PA 61 of 2004 (Marshall & Rossman, 1999). Capitol Services, Inc. was included in the list of initial contacts. Capitol Services, Inc. was the multi-client lobbying firm hired in 1989 to represent MI-National Association of Social Workers. This contractual relationship between the two organizations identified Capitol Services, Inc. as an organization of interest for the intent of this research. The initial contacts produced 14 responses (52%) from potential participants (see Table 5). A decision was made not to contact the School of Social Work at Michigan State University during the initial contacts. This was done to allow participants to refer 33 Table 5 Initial Respondents Darrell Tennis Curtis Hertel, Jr. Kathy PalazollO-Miller Pete Weidenaar Nadine Nosel Linda Burghardt Jim Haveman Dave Neal David Finkbeiner Amy Zaagman Dave LaLumia Jean McFadden Pat Stankewitzl Robert Miles2 Capitol Services, Inc. MI Department of Community Health, Granholm Administration MI Association of Bachelor of Social Work Educators/Ferris State University MI National Association of Social Workers United Auto Workers MI National Association of Social Workers Department of Community Health, Engler Administration MI Board of Social Work MI Health and Hospital Association Senator Hammerstrom’s Office MI Association of Community Mental Health Boards MI Board of Social Work MI Catholic Conference MI Federation for Children and Families er. Stankewitz was not involved in passage of the bill. He sent an email to document that MCC submitted a letter of support for the bill to Senator Hammerstrom’s Office at the request of the MCC’s Social Policy Committee. See Appendix F, Documents. 2Schedule conflicts prevented this interview. the researcher to an appropriate representative of the University along with other representatives of schools of social work in the state. Furthermore, no contact was made with a representative of the Engler Administration, Governor’s office, because no contact 34 information was available. This contact was deferred to allow participants to identify a representative of Governor Engler’s office. Thirteen of the initial contacts did not respond (48%). A follow up email/letter was sent to all those who did not respond (Grinnell, 2007). As a result of the follow up contact, one potential participant agreed to an interview resulting in a response rate of 56% and a non-response rate Of 44%. Twelve interviews were completed from the list of initial respondents during the fall of 2007. Other potential interviewees were identified using a referral technique, called snowballing sampling (Seidman, 1998). Snowball sampling is often used in qualitative research and makes use of initial contacts to identify other potential participants (Coolican, 1999; Darker, Larkin & French, 2007; Henry, 1990). An assumption of snowball sampling is that a network exists within a population and that the participants know each other through the network (Singleton & Straits, 1999). Snowball sampling is used when members of a population can not be easily identified (O’Sullivan, Rassel & Bemer, 2003). In this case, it is assumed that the representatives and their organizations, the population of the study, know and are aware of each other through an existing network. This referral technique generated a list of 24 potential participants. Interviews were completed with nine representatives from the referral list (see Table 6). The nine interviewed participants were selected for their position in support or opposition, the ability to gain access (Bogdan & Knopp-Biklen, 1998), and the resources required for the time and travel to complete the interviews (O’Sullivan, Rassel & Bemer, 2003). Over all, the sample consisted of 21 interviewed participants (see Tables 7 and 8). The sample was a nonprobability sample and useful for this study because a sampling frame, from which to draw a sample representative of the 35 population, was not available nor the resources to generate one (Marshall & Rossman, 1999; Riffe, Lacey & Fico, 2005). The sample for the study was a purposive sample. Participants were chosen using a deliberate but non-random process (Singleton & Straits, 1999). Table 6 Interviewees by Referral Ellen Hoekstra Capitol Services, Inc. Monica Martinez Senate Liaison, Granholm Administration, Governor’s office Bill Lobenherz MI Association of Marriage and Family Therapists Floyd Smith AuSable Valley Community Mental Health Sue Bowden MI Association of Bachelor of Social Work Educators/Michigan State University Stacey Hettiger Republican House Policy Office Jeff McAlvey Director of Legislative Affairs, Engler Adrrrinistration, Governor’s office Maxine Thomel MI National Association of Social Workers Marjorie Zeifert MI Association of Bachelor of Social Work Educators/Eastem Michigan University lM. Thome was an initial contact and responded for an interview after a follow up contact. However, she was also identified by other interviewees as a person to interview. 36 Table 7 Participants: Groups, Organizations and Public Ofi‘icials in Support of MI PA 61 of 2004 Participant Darrell Tennis Pete Weidenaar Linda Burghardt Ellen Hoekstra David Finkbeiner Dave LaLumia Maxine Thome Kathy Palazollo- Miller Floyd Smith Sue Bowden Marjorie Zeifert Position when MI PA 61 of 2004£assed Co—founder Former Executive Director Government Relations Director Co-founder Senior Director Executive Director Executive Director Vice-President of Executive Board Executive Director President Executive Board Organization Capitol Services, Inc. — organization of interest MI-National Association Of Social Workers MI-National Association of Social Workers Capitol Services, Inc. - organization of interest MI Health and Hospital Association MI Association of Community Mental Health Boards MI-National Association of Social Workers MI Association of Bachelor Social Work Educators AuSable Valley Community Mental Health MI Association of Bachelor of Social Work Educators MI Association of Bachelor of Social Work Educators Current Position Same Retired/Board of North American Association of Christian Social Workers Same Same Sr. Vice President for Advocacy Same Same President/Faculty, Ferris State University Same Faculty, Michigan State University/BSW Coordinator Faculty. Eastern Michigan University/Director of School of Social Work Curtis Hertel Legislative Analyst Department of Community Legislative Liaison Health/Granholm Administration Dave Neall Former President MI Social Work Board Retired/Emeritus Faculty/University of Michigan Amy Zaagman Chief of Staff Senator Hammerstrom’s Associate Director MI Office Association of CMH Boards Jean McFadden2 Board Member MI Social Work Board Board/Faculty, Grand Valley State University Stacey Hettiger House Liaison House Republican Policy Senate Majority Policy Office Office Monica Martinez Deputy Director of Governor Granholm’s MI Public Service Legleation Office Commission lDave Neal was a long time supporter of social work licensure. However, as an appointed member of the MI Board of Social Work he remained neutral on MI PA 61 of 2004. 2Jean McFadden was also a long time supporter of social work licensure. As an appointed member of the MI Board of Social Work, she maintained a neutral position. 37 Table 8 Participants: Groups, Organizations, and Public Ofi‘icials in Opposition of MI PA 61 of 2004 Participant Position when MI Organization Current Position PA 61 of 2004 passed Nadine Nosel Legislative United Auto Workers Same Coordinator Bill Lobenherz Lobbyist MI Association of CEO/MI Soft Drink Marriage and Family Association Therapists Jim Haveman Director Department of Mental Consultant/Public Health, En gler Speaker Administration Jeff McAlvey Director of Governor En gler’s McAlvey and Legislative Office Associates Affairs Interviews with participants were completed from September 2007 through January 2008. When 21 interviews were completed, it was decided by the researcher that the information was consistent and no new information was evident. According to Creswell (1998) and Grinnel (2007), a sample size of 20-30 was sufficient to generate enough data for analysis to fill the categories formulated from the theories when applying an a priori coding strategy. The decision was made to end the interviews with 21 completed due to the consistency Of the information and sufficiency of the sample size (Siedman, 1998). According to Yegidis and Weinbach (2002), a nonprobability sample is useful for a qualitative study because there is no intent to generalize the findings from the sample to a population as in is done in quantitative research (Singleton & Straits, 1999). Rather, 38 qualitative research relies on analytic generalization that focuses on the generalizability of the findings from one case to the next (Franklin & Ballan, 2001). Data Collection Methods Interviews Interviews were used to collect the data for this study. Interviews enriched the collection of data and provided details of the policy change process (Allen- Meares & Lane, 1990; Holosko, 2001; Polkinghome, 2005). Also, the interviews allowed for the collection of a large amount of data in order to gain an understanding of the interviewees’ perspective on the passage of MI PA 61 of 2004 (Marshall & Rossman, 1999). Participants were recruited for the interviews by the researcher through email/letter (see Appendices A7 and Bs). Interviews were scheduled as potential participants responded. A mutually agreed upon time and place was arranged and a follow up email or letter was sent to the participant. The email or cover letter again introduced the participant to the project and verified the date, time and place for the interview (O’Sullivan, Rassel & Bemer, 2003). Prior to each interview, the researcher provided the potential participant with a consent form for their review and signature, and answered any questions asked by the participant (Grinnell, 2007; Reamer, 2001). A consent form for participants developed by the supervising professor for another research project was adapted by the researcher and met the requirements of the “Consent Form Guidelines” developed by the Institutional Review Board (IRB) of Michigan State University (see Appendices C and D). Research 7From State Legislative Histories by C. Jackson-Elmoore, 2006, Michigan State University, IRB Exempt Study, X05-986. Adapted with permission. 8Ibid. Adapted with permission. 39 standards of IRB are consistent with the MI National Association of Social Workers’ Code of Ethics (1999) specific to Section 5.02, Evaluation and Research. Interview data was collected using a semi structured interview protocol (see Appendix E). The protocol was used for supporters, opponents and public officials. The interview protocol was piloted with two individuals identified by reputation as involved in the policy making process.9 Pilot interviews were completed with a representative of the Traverse City Campaign Against Discrimination who successfully advocated in opposition to an amendment to the Charter of the City of Traverse City, MI in 2001. A pilot interview was also done with a current member of the Michigan Protection and Advocacy Board who worked for the passage of the American Disabilities Act of 1990. As a result of the pilot interviews, the interview protocol was revised for clarity and relevance. One of the questions was eliminated for its redundancy. Another was added to allow for participants to identify other potential interviewees known by reputation for support or opposition of MI PA 61 of 2004. The interview protocol consisted of a series of ten questions organized around the research questions (see Table 9). Each of the ten questions included a series of questions that allowed the researcher to probe for information (Goodman, 2001). The questions were designed to examine the extent and nature of the support or opposition for social work licensure as well as the context in which the legislation passed. Sixteen of the interviews were conducted within a one-hour time frame. Exceptions occurred with five interviewed participants. These participants required approximately a 90-minute interview. All interviews were tape recorded. Sixteen of the 21 interviews were 9These individuals were not involved in the passage of MI PA 61 of 2004. 40 conducted face-to—face in an office or a mutually agreed upon location (Grinnell, 2007). One of the interviews was conducted in the balcony of the Michigan Senate and another in a quiet lobby area in the Capitol due to schedule conflicts. Five of the interviews were phone interviews. One of these phone interviews was requested by the participant. The other four were requested by the researcher. In these situations, the consent form was mailed with the cover letter and instructions to return the signed and dated consent form to the researcher in a self addressed stamped envelope. Table 9 Overview of Interview Protocol and Research Questions 10. What is your current position? (Group, organization, public official ) What is your background and involvement in relations to social work licensure? (past position, interest in licensure, years of involvement in public policy and social work licensure) What was your involvement in the passage of the legislation between 1990 and 2004? (group, organization, public official, position and responsibilities) What was the position of your organization in support or opposition of the legislation? (position in support or Opposition, rationale for position, roles and activities to promote position) How did your organization align with other individuals or organizations in support or opposition of the legislation? (see Research Question 2) What changes occurred in the alignments and relationships over the l4-year period? (see Research Question 3) What changes occurred in the political context that affected the activities and efforts of your organization? (see Research Questions 1, 4, and 5) What critical events and other factors influenced the passage of MI PA 61 of 2004? (see Research Question 6) What else do I need to know about support for or opposition of the legislation? (Probe Question) Is there anyone else I should interview in regard to support or opposition of MI PA 61 of 2004? (Referral Technique Question) 41 Documents The documents analyzed for the research included legislative documents, organizational documents and news reports. Legislative documents relevant to the passage of MI PA 61 of 2004 for the years 1997-2004 were accessed through the Michigan Legislative Website (http://www.legislature.mi.gov) as well as the Republican Majority Policy Office, and the Secretary of the Senate. Legislative documents for the years 1990-1996 were accessed through the Northwestern Michigan College Library in Traverse City and the Michigan Library in Lansing. Organizational documents were provided by representatives of the groups and organizations involved in the passage of social work licensure. These documents were provided by interviewed participants at the time of the interview or mailed/emailed to the researcher. Newspapers were accessed through Michigan State University’s and Grand Valley State University’s Library Electronic Resources using the database Newsbank (http://infoweb.newsbank.com). The major criterion for inclusion of legislative, organizational and news documents was the generation of the document by an individual, group or organization in support or opposition of social work licensure during the l4-year period. Documents and news reports produced during the time frame 1998-2000 as well as 2002-2004 were targeted for events that occurred during this period to impact the regulation of social work. In 2000, MI PA 11 of 2000 transferred the functions and authority of the Board of Social Work Examiners from the MI Occupational Code to the Public Health Code. In 2003, the Granholm Administration took office. MI PA 61 of 2004 became law in 2004. 42 Legislative documents used in the study included House and Senate Journals, Senate Health Policy Minutes, Bill Analyses and Enrolled Bills. Organizational documents included position papers, board minutes, the history of social work regulation in Michigan, letters, emails, and memos. A purposive sample of newspaper articles from the three primary media markets of Detroit, Grand Rapids and Lansing was included in the analysis. Newspapers from these areas included the Detroit Free Press, Detroit News, Grand Rapids Press, and Lansing State Journal. A Boolean search of “social wor ” AND “license” using the online database Newsbank produced four articles on social work licensure in Michigan for the targeted time frames of 1998-2000 and 2002-2004. Organizational documents and all legislative documents are listed alphabetically by authors under References. Other documents that include emails, memos, position papers, and correspondence were sorted by author, organization, and date of the document. These documents are located in Appendix F. The inclusion of documents in the study broadens the methods of data collection and allows for the triangulation of data. According to Singleton and Straits (1999), two methods of data collection do not share the same weaknesses. Therefore, if two methods whose pattern of error varies from each other produce the same result, then confidence in the results increases. Triangulation of the data increases the trustworthiness of the study through a cross checking process that uses the different data sources to provide an interpretation that is congruent with the divergent data sources (Franklin & Ballan, 2001). 43 Case Study Analysis The goal of this case study analysis was to interpret the influence of the relationships and activities of groups, policy monopolies, and other critical events on the passage of MI PA 61 2004. The theoretical concepts of the ACF and punctuated equilibrium theory guided data collection and analysis. It was proposed that the passage of MI PA 61 of 2004 was the result of: 0 Election of a new governor 0 Alignment and activity of groups, organizations and public officials in support and opposition over the l4-year period. 0 Changes in the alignment and activity of the groups, organizations, and public officials in support and opposition over the 14-year period. 0 Changes in policy venue 0 Expansion of the policy image 0 Other critical events Refer to Tables 10 and 11 for the definitions of the variables. To assist with the analysis, Interview and Document Coding Protocols were developed prior to data collection using the predetermined coding agenda (see Appendix G). Both the Interview and Document Protocols were revised during data collection (see Appendices H and I). A Code Book was also written and revised during data collection to clarify rules for coding both the interviews and documents (see Appendix J). As interviews were completed, the audio tapes were transcribed into Microsoft Word text files. As tapes were transcribed, the interview transcripts were read through once. The interview transcripts were then read a second time and hand coded using the 44 coding protocol (Creswell, 2003, Marshal & Rossman, 1999; Seidman, 1998). The researcher continued to review and hand code the interview transcripts until the coding strategy was established. Interview text files were then loaded into the NVivo qualitative software program. Table 10 Operational Definition of Variables Election of a new governor Alignment and activity of groups, organizations and public officials in support and opposition Changes in alignment and activity of groups, organizations and public officials in support and opposition Change in policy venue Expansion of the policy image Other critical events Election of Governor Jennifer Granholm in support of licensure following Governor Engler in opposition Stable alignment of groups, organizations and political institutions in support from 1990-2004. Shifts in alignment of groups, organizations and public officials from support to opposition or vice-versa from 1990-2004 Transfer of the regulation of social work from the MI Occupational Code to the MI Public Health Code Refer to Table 11 for public understanding of social work licensure Efforts to mobilize stakeholders to contact policy makers and the consideration of any other social, economic or political condition 45 Table 11 Public Image of Social Work Licensure Image Definition Bureaucracy Expansion Cost Increase Job Protection Last State to License Public Protection Restriction of Services Scope of Practice Title Protection10 Free Market Protection Increased control and responsibility of the Department of Community Health over regulation Increased cost for government to employ staff to oversee regulation Licensure as a threat to the positions Of employees of the Department of Human Services Michigan as the last state to license social work Licensure as protection of the health, safety, and well being of the public Decreased services due to restricting access to the profession thus limiting others without social work degrees from providing services Practice specific to the functions of LBSW and LMSW considered as equitable with the scope of practice with other health professionals Use of the title “social worker” by only those licensed to practice Licensure as a threat to market protection due to restricting access to the profession thus driving up costs and limiting consumer choice 10 . . . . . . . . Trtle Protection was eliminated during data collection. Last State to License and Free Market Protectron were added. 46 Once interview files were loaded, the coding strategy of the Interview Protocol was applied using the following categories: 0 Scope of policy making community 0 Changes in institutional structure 0 Critical Events 0 Expansion of the public image 0 Other critical events or factors Interview transcripts were coded for phrases and sentences representative of the categories (see Table 12). The category of scope of the policy making community was detailed using units of data from questions one through four and question ten in the interview protocol specific to: (a) Who were the individuals, groups and organizations? (b) How long were they involved in the process? (0) What were their positions on licensure? Data for the category of institutional change was detailed using units of data from questions five and six specific to changes in institutional structures or shifts in the alignments of organizations over the l4-year period. Data for the category of critical events was detailed using units Of data from questions seven, eight and nine specific to: (a) Engler Administration; (b) Governor Jennifer Granholm’s; and, (c) behavior to mobilize stakeholders. Data to analyze the public image of licensure was drawn from the interviews according to the participants’ understanding of licensure as bureaucracy expansion, cost increase, job protection, last state to license, public protection, restriction of services, scope of practice, and free market protection. 47 Table 12 Coding Categories as a Framework to Collect Data Using Interview Protocol Questions Category Research Questions Scope of Policy Making Community Change in Institutional Structure Critical Events 1. What is your current position? (Group, organization, public official ) 2. What is your background and involvement in relations to social work licensure? (past position, interest in licensure, years of involvement in public policy and social work licensure) 3. What was your involvement in the passage of the legislation between 1990 and 2004? (group, organization, public official, position and responsibilities) 4. What was the position of your organization in support or opposition of the legislation? (position in support or opposition, rationale for position, roles and activities to promote position) 10. Is there anyone else I should interview in regard to support or opposition of MI PA 61 of 2004? (Referral Technique Question) 5. How did your organization align with other individuals or organizations in support or opposition of the legislation? (see Research Question 2) 6. What changes occurred in the alignments and relationships over the 14-year period? (see Research Question 3) 7. What changes occurred in the political context that affected the activities and efforts of your organization? (see Research Questions 1, 4, and 5) 8. What critical events and other factors influenced the passage of MI PA 61 of 2004? (see Research Question 6) 9. What else do I need to know about support for or opposition of the legislation? (Probe Question) 48 Once completed, the categories were reviewed for content and cross referenced with the interview documents for accuracy (Franklin & Ballan, 2001). This process continued until inaccuracies were corrected and a decision made that the content reflected the intent of the category. A case-by-variable matrix was then designed to cross- reference the content of the interview transcripts of each participant with the predetermined categories (McTavish & Loether, 2002). The intent of the matrix was to assist with efficient organization of a large amount of data while remaining alert to alternative themes that might emerge (Marshall & Rossman, 1999). The categories of the matrix represented variables identified as those that influenced the passage of MI PA 61 of 2004 (see Appendix K). A matrix layout provided a visual tool to assist with identifying and interpreting the patterns emerging from the case files that were consistent with the categories (Richards, 2005). Furthermore, the matrix assisted with the identification of other patterns or themes that emerged from the content of the interviews. The legislative documents provided content to construct a legislative history of MI PA 61 of 2004. Organizational documents and news reports were analyzed for their content to identify the scope of the policy making community, influence of changes in institutional structure and critical events on passage of the legislation. All documents were read and sorted for their relevancy to the intent of the research. Documents were read a second time and sorted as a legislative, organizational or news report document. The documents were read a third time and hand coded using the Document Coding Protocol. Documents were then scanned into the NVivo qualitative software program and coded using phrases and sentences representative of the same 49 categories established to code the interview files. When coding of the documents was completed, the categories were reviewed for content and cross referenced with documents for accuracy (Franklin & Ballan, 2001). A matrix was also designed and used to cross reference the content of the documents with the categories to identify and interpret the emerging patterns (see Appendix L). Summary This chapter provided a rationale for the selection of the case and the construction of a nonprobability sample consistent with the use of a qualitative methodology. Interviews and document analysis were the methods used for data collection. The interviews, using a nonstandardized instrument, allowed the experiences of the participants to influence data collection and analysis (Marshall & Rossman, 1999). Document analysis permitted the triangulation of data and contributed to the validity of the research (Singleton & Straits, 1999). A purposive sample of 21 participants representing 15 groups and organizations was used for the research. Documents included organizational and government documents as well as newspapers. The data was represented with numeric and text data. Matrices were designed to efficiently organize a large amount of data for analysis. A limitation of the study was its use of a nonprobability sample and a non- standardized instrument measure that did not permit the results of the case study to be generalized to the population. However, the qualitative methodology did permit an interpretation of the data specific to the case of MI PA 61 of 2004. 50 Chapter Four presents the legislative history of MI PA 61 of 2004. The chapter begins with the early history of licensure and traces the introduction of seven social work licensure bills from 1990-2003, culminating in the passage of MI PA 61 of 2004. 51 CHAPTER 4 CASE STUDY Michigan Legislative History of Social Work Licensure: 1990-2004 Early History: 1 989-1 990 In 1989, MI-National Association of Social Workers, a membership organization of professional social workers, developed a contractual relationship with Capitol Services, Inc., a multi client lobbying firm, to represent the organization in its efforts to license social workers (MI-NASW, 2005). The leadership of MI-NASW approached Capitol Services, Inc. due to its success in representing the Michigan Counseling Association when counselors were licensed in Michigan. According to a representative of an organization in support: In about 1989, a group [representing MI-NASW] met with Debbie Stabenow, who was a legislator at the time, to talk about licensure. . .She. . .suggested that we consider Capitol Services. [The chapter took] her advice and hired Capitol Services (in person interview, organization in support, September 20, 2007). At this time, MI-NASW in consultation with Capitol Services, Inc. developed a strategic plan to accomplish the goal of licensure. The plan incorporated: (l) advancing MI-NASW as the spokesperson for the profession; (2) developing a positive relationship with the Board of Social Work Examiners; (3) bipartisan sponsorship and introduction of a bill simultaneously in both the House and Senate; (4) mobilization of membership in support of a bill; (5) and consideration of a bill to transfer regulation from the 52 Occupational Code to the Public Health Code (MI-NASW, 2005). A representative of an organization described the process Of working with MI-NASW. The individual stated: ...We sat down and looked at the history of the issue, how it got to this level and what the goal of the chapter was. Then, why hadn’t it been done before? What were the reasons? What was the difficulty? We then laid out a written plan to solve the problems. . .an actual lobbying plan that involved everything from who should sponsor the bill, what kind of legislator, how should we develop the materials, and how should the chapter structure itself to work with this effort... (in person interview, organization in support, September 10, 2007). Throughout the 14-year period, MI-NASW and Capitol Services, Inc. worked closely for the implementation of the legislative strategy. History of Social Work Licensure: 1990-2004 As a result of the contractual relationship between MI—NASW and Capitol Services, seven social work licensure bills were introduced in the Michigan Legislature from 1990-2004 (see Figure 2). MI-NASW in consultation with Capitol Services, Inc. worked throughout the period to draft legislation, identify sponsors for the legislation and mobilize Chapter members to contact legislators. The bills included: 0 H.B. 5004 of 1990 o H.B. 4491 Of 1991 0 SB. 0617of1993 o H.B. 4813 of 1995 0 H.B. 4274 of 1997 53 .voom ”WWW“ i=2 OOEEECO $08900 83:00: 550 8 EB ea 9 030 800: E 605 .0000 o a a poems. 58300 05 3 30:5 .0308 5:83 0:25 05 005558 OHS—om : MM: o mw 05 one 8003 05 33am .0000 9 coogmmwoc 0:03 3 005 .8503 05 518$ ”:55 05 8 €03 300m 308 5.555 8 Emma 60030005 85900 @8020 5.353 9 coo—6055 :9 mm 30:000.: Soo mm . 33 mi 50:55 cores—0H 38 _ 88 _ 88 _ 82 _ 5.: _ nae _ 82 _ 32 _ 82 _ .280 £83 255 05 3:38 9 0103 308 C0 0055mm”: 850m 5 00:. Em 8.30800 5 0:03 outcomeeh .ooom o0 .3000 530m 0:03 05 .. . 300m 8000: 9 , . 9 0:03 308 Comma—ab 3% Em 85300 30:85:. ow_ o mm : mum~mmw3 GawF—UE ”Dcm—OEMH Row—03$ N oSmE 54 0 SB. 0657 of 1999 0 SB. 0189 of 2003 The language of the bills was crafted to respond to issues of licensure relevant to social work such as the transfer of social work regulation from the Occupational to the Public Health Code, a defined scope of practice for the BSW and MSW, and the establishment of continuing education requirements (see Table 13). Groups, organizations and public Officials aligned in support and opposition of the bills throughout the 14-year period (see Table 14). House Bill 5004 of 1990 House Bill 5004 of 1990 (see Appendix M) was co-sponsored by Democratic Representatives Gubow (District 35), Stabenow (District 58), Leland (District 13), and Gire (District 31). At the time the bill was introduced, Democrats were the majority party in the House and supportive of licensure. Co-sponsors of the bill also included three social workers-Representatives Stabenow, Leland and Gire. The bill was also positioned for passage in the Senate in the fall of 1990 and Democratic Governor Blanchard was committed to sign the bill. A representative of an organization stated, “We knew when it got to the floor that we had the votes and we had more than a majority” (in person interview, organization in support, September 10, 2007). Another representative of an organization stated, “[H.B. 5004 of 1990] was ready to go... [Representative Gubow] was the House sponsor and we had a whole plan including the Senate worked [out]” (in- person interview, organization in support, November 15, 2007). 55 Table 13 Language of Social Work Licensure Bills from 1990-2004 Scope of Practice Social Work Technician Exceptions Transfer of Regulation to Public Health Code Standards of Practice Board of Social Work Grandparenting Continuing Education Throughout the l4-year period, legislation proposed a definition of the scope of practice for LBSW and LMSW. An affidavit for the practice of psychotherapy was proposed consistently but eliminated with the passage of SB. 0189 of 2003. Educational, employment, and supervision criteria were included in all bills. SB. 0189 of 2003 also included a distinction between micro and macro practice. The category of technician was eliminated in the earliest versions of the bills but reinstated in all other versions. SB. 0189 of 2003 changed the name of the category to social service technician. Early versions of the bill included exceptions for state civil service employees. SB. 0189 of 2003 included compromise language for the LBSW as voluntary but did not exempt civil service employees. All versions of the bill included language for the transfer until the passage of SB. 0657 of 1999 that transferred regulation as MI PA 11 of 2000. Confidentiality standards were included in all versions of the bill. Establishment of the Board of Social Work was included in all versions of the bill and achieved with the passage of SB. 0657 of 1999. Language was included in later versions of the bill and achieved with the passage of SB. 0189 of 2003. Language was included in later versions of the bill and achieved with the passage of SB. 0189 of 2003. Source: Arasim & Linauist (1993); H.B. 5004 of 1990; H.B. 4491 of 1991; H.B. 4813 of 1995; H.B. 4274 of 1997; SB. 0617 of1993; SB. 0657 of 1999; SB. 189 of 2003; Rosenblatt (2003); Stutzky (1998;1999). 56 Table 14 Group Alliances: Social Work Licensure from 1990-200411 Bill Support Opposition Neutral H.B. 5004 of MI-NASW Department of Public Department of Social 1990 Health Services MI-Society of Clinical Social Work MI Consumers New Detroit, Inc. Council MI Association of School Social Workers MI National Association of Black Social Workers H.B. 4491 of MI-NASW Economic Alliance of 1991 M1 M1 Association of Professional MI Hospital Psychologists Association MI Psychiatric MI Consumers Association Council H.B. 4274 of MI-NASW 1997 Department of Consumer and Industry Services SB. 0657 of MI-NASW 1999 Department of Consumer and Industry Services SB. 0189 of 200312 Source: Arasim & Tyszkiewicz, 1999; MI Legislature (1990a; 1990b; 1991a; 1991b; 1991c); Nagata & Tyszkiewicz (1998); Stutzky (2004). However, in the fall of 1990, Capitol Services, Inc. was approached by a representative of Governor Blanchard’s office with a request to wait until after the November election to 11Information on all bills was not available. 12See Table 1 57 bring the bill through the Senate. According to the representative of an organization, Governor Blanchard’s spokesperson indicated that, We’re getting some [resistance] from our State Departments, and the hospitals aren’t too happy but we will sign it when it comes to us, assuming you get it through the Senate. But, ...we would ask that you not run it through the Senate until after the election’ (in person interview, organization in support, November 15, 2007). MI-NASW agreed to wait. Republican John Engler was elected governor over Jim Blanchard. Following the election of John Engler, a public hearing on H.B. 5004 was held in the Senate Health Policy Committee and a vote scheduled for November 29, 1990 (M1- NASW, 2005). However, Engler, prior to assuming Office as Governor and as the Senate Majority Leader, decided that no bills would be taken up during the lame duck session. A representative of an organization in support stated, “Engler canceled all of the meetings. . .We had a meeting of the Senate [Health Policy] Committee [scheduled] ...Senator Schwartz sat [on this Committee and was] the sponsor of the bill. . .essentially that took care of licensure [for the next 12-years]” (in person interview, organization in support, September 20, 2007). According to a representative of an organization, , “[Engler] opposed [licensure] very strongly. . .social work licensure was one of two bills that had caused him [to cancel all meetings]” (in person interview, organization in support, November 15, 2007). As a result of the election of Governor Engler, H.B. 5004 of 1990 died in committee. 58 House Bill 4491 of 1991 Another social work licensure bill, H.B. 4491 of 1991, was introduced in the House by Democratic Representative Gubow (District 35) in the next legislative session (see Appendix N). The bill was the same bill as H.B. 5004 of 1990. This decision to reintroduce the same bill was predicated on the belief that the bill would move easily through the Democratic controlled House under the sponsorship of Representative Gudow and would provide an opportunity to assess the position of the Engler administration on licensure. A representative of an organization stated, We went with the same bill essentially because we wanted to test the resolve on the part of the Governor not to agree to license. We also developed a ...relationship with Senator Pridnia who was a Republican Senator who chaired the Health Committee in the Senate. Pridnia was positive and helpful [regarding the issue of licensure]...folks in the administration that came in under Engler’s administration. . .were not particularly adverse [to licensure] (in person interview, organization in support, September 10, 2007). A representative of an organization in opposition described Republican Senator Pridnia (District 36) as a strong advocate for social work licensure who had an agreement with the Blanchard Administration to move licensure forward. The individual indicated that, Senator Pridnia was pushing social work licensure and I think had a commitment from the Blanchard administration that they supported it. Well, Blanchard lost and Governor Engler took over and I can distinctly 59 remember the day I had to go tell Senator Pridnia that we were not in support of the licensure bill. He was not happy (in person interview, organization in opposition, November 2, 2007). Senator Pridnia continued to pursue the position of the Engler administration on licensure. Governor Engler responded to his requests in a letter. The Governor clarified his position on licensure as only necessary when “compelling evidence” is present to protect the “health, safety, and welfare of the citizens.” It was Engler’s opinion that unnecessary regulation, by restricting access to a profession, removed the “economic benefits provided by competition and a free market” and increased costs to consumers while reducing services. Also, Engler indicated that the review of threats to the public safety related to the regulation of social work was transferred from the Department of Licensing and Regulation to the Bureau of Occupational and Professional Regulation in the Department of Commerce (John Engler, personal communication, October 16, 1991).‘3 Senator Pridnia then requested information from the Bureau of Occupational and Professional Regulation as to what type of proposal other than licensure would be acceptable to the Engler Administration. Kathy Wilbur, Director of the BOPR, responded to his request. In a letter to Senator Pridnia, Director Wilbur stated, The administration opposes unnecessary licensure of occupations; that includes changing the level of social work regulation from registration to licensure. They would have no particular concern if social work regulation were moved from the Occupational Code to the Public Health Code, 13See Appendix F, Documents. 60 provided that social workers remain registered, not licensed (Kathy Wilbur, personal communication, July 9, 1992).14 Senator Pridinia informed MI-NASW of the position of the Engler Administration on social work licensure. In a letter to the organization, he stated, While it is clear that the pursuit of licensure is not possible during this legislative session, I am encouraged that all of the involved parties are moving toward a timely resolve. Please let me assure you that I, as Chair of the Senate Health Policy Committee, will continue to work. . .so that the needs and goals of your profession are addressed. I also want to assure you that if the atmosphere becomes more conducive towards licensure, social work licensure will certainly be in the first list of issues brought to the Health Policy Committee for consideration... (John Pridnia, personal communication, September 18, 1992).'5 House Bill 4491 of 1991 died in the Senate Health Policy Committee at the end Of the legislative session. Senate Bill 061 7 of I 993 Senator Pridnia remained consistent in his support of social work and was the primary sponsor of SB. 0617 of 1993 when he assessed the willingness of the Engler Administration to support a bill that was less than licensure (see Appendix 0). The bill was co-sponsored by Republican Senators Dillingham (District 30), McManus, Jr. l4Ibid. Ibid. 61 (District 37), Gougeon (District 34), Emmons (District 23), Dunaskiss (District 16), Cisky (District 33), Ehlers (District 28), Hoffman (District 19), and Democratic Senators Pollack (District 18), Kelly (District 1), Kovisto (District 38), and O’Brien (District 5). The Board of Directors Of MI-NASW in a licensure update to its membership endorsed SB. 0617 and stated, Unlike last year’s H.B. 4491, SB. 0617 would not license social workers. This bill would move social work registration to the Public Health Code, incorporate much of the substance of the current rules into law, keep the present Board of Examiners of Social Workers, and through these changes, strengthen the registration process (MI-NASW, personal communication, April, 1993).16 Senate Bill 0617 of 1993 proposed the transfer of the registration of social workers from the Occupational Code to the Public Health Code in order to “strengthen social work registration requirements by moving them from administrative rule into law including more specific educational and experience requirements” (MI-NASW, personal communication, April 1993).'7 However, the bill stalled and died in the House Committee on Public Health due to the concerns of the Department of Mental Health, MI Association of Community Mental Health Boards and the opposition of the Bureau of Occupational and Professional Regulation. Their opposition was specific to the requirement that in order to register as a social worker, a bachelor degree in social work was required (MI-NASW, 2005). 62 In a memo to the Community Mental Health Directors, the Associate Director of the MI Association of Community Mental Health Boards wrote, ...The Association has been working to impact the discussions on licensure of social workers in Michigan, seeking changes that protect the title of social worker without increasing costs to the public mental health system and restraining the use of other qualified individuals by CMH boards. Last year, we succeeded in stopping a bill [H.B. 4491] that attempted to artificially carve out a scope of practice for social workers that would have severely limited the use of individuals who did not have social work education (Jean LaVassaur, personal communication, September 4, 1992).'8 According to a representative of an organization, We had Pridnia introduce a bill and move it from the Senate side over to the House. . .there were demands made by the administration. They didn’t want to deal with the bachelor level at all. They didn’t want that in the Public Health Code (in person interview, organization in support, September 10, 2007). Amendments were offered, as supported by the Governor, that removed the requirement of the bachelor of social work along with removal of the provisions to codify the rules. The Executive Board of MI-NASW did not support the amendments. The bill failed to report out of committee (MI-NASW, 2005). 18Ibid. 63 A representative of an organization stated, We weren’t going to split off levels of social work. Most states only license social work at the master’s and doctoral levels. They don’t license the bachelor level at all. We decided early on that we were not going to do that. ...We were offered that deal many times during the process (in- person interview, organization in support, September 10, 2007). Another representative of an organization in support stated, One of the reasons we had such a tough time [getting licensure] in Michigan is because we, the chapter, refused to bend on wanting to regulate the whole profession [BSW and MSW]. We could have probably gotten licensure earlier if we were willing to license one segment [MSW] of the profession (in-person interview, organization in support, September 20, 2007). House Bill 4813 of 1995 In the next legislative session, H.B. 4813 of 1995, another social work licensure bill, was introduced (see Appendix P). House Bill 4813 of 1995 was co-sponsored by Democratic Representatives Gubow (District 35), Leland (District 13) and Gire (District 31). According to a representative of an organization, this bill was introduced knowing that Governor would not sign it if it passed the legislature. He stated, We couldn’t just drop this and not put in a bill every year and not educate, not keep the legislators informed. . .because if we did, we would drop out of line and there would be 20 other groups waiting to take [our] place. 64 ...Eventually, the governor would change. ...You had to be first in line (in-person interview, organization in support, September 10, 2007). House Bill 4813 of 1995 died in the House Committee on Health Policy. House Bill 42 74 of 1997 Then in 1997, H.B. 4274 was introduced by Representative Gubow (D-District 35) and referred to the House Committee on Health Policy (see Appendix Q). The bill again proposed the transfer of the registration of social workers from the Occupational to the Public Health Code. The bill passed both the House and the Senate but was vetoed by '9 “to two other bills that were dealing with licensing Governor Engler due to a tie bar issues for nutritionists, dietitians, and athletic trainers” (MI-NASW, 2005). According to a representative of an organization in support, the Governor was specific to address that his veto “had nothing to do with moving social workers [from the Occupational Code to the Public Code]” (in-person interview, organization in support, November 15, 2007). Senate Bill 065 7 of 1999 In the next legislative session, SB. 0657 of 1999 was co-sponsored by Republican Senator Shugars (District 21) and Democratic Senator Leland (District 5) and referred to the Senate Committee on Economic Development, International and Regulatory Affairs (see Appendix R). The bill again proposed an amendment of the Public Health Code for the registration and regulation of social work and a repeal of Article 16 of the Occupational Code. The bill moved successfully through the Senate and 19Only one tie bar was identified in the legislative record-H.B. 5736 of 1997 to amend the Nonprofit Health Care Corporation Reform Act that regulated Blue Cross Blue Shield of M1 to specify that health care corporations are not required to provide benefits/reimbursement services to athletic trainers licensed under the Public Health Code. 65 the House and was referred to the Governor. The bill was approved by the Governor and filed with the Secretary of State as MI PA 11 of 2000. A representative of an organization in support stated, “By moving into the health code, we became more accountable to the public. We fell under the provisions of the health code and that was, again, perceived as. . .of a strategic positioning for licensure” (in-person interview, organization in support, November 19, 2007). Another representative of an organization in support stated, “I think the argument always had been that the Public Health Code is where we regulate health professionals. I think people just understood that was the more appropriate act to govern the profession” (in-person interview, organization in support, December 13, 2007). Not only did the passage of SB. 0657 of 1999 position social work for licensure but it also provided the Board of Social Work more authority to regulate the profession. A representative of an organization in support indicated, “What we finally did was move social work regulation, with the Engler Administration’s blessing, into the Public Health Code because that gave the board more power” (in-person interview, organization in support, November 15, 2007). Senate Bill 0189 of 2003 In 2001, the long term Executive Director (1977—2001) of MI-NASW retired without the achievement of social work licensure. However, he stated, “. . .When I left, I knew it would pass with the election of a new governor” (in-person interview, organization in support, September 20, 2007). The new leadership of MI-NASW identified licensure as a goal of her tenure. She stated, “[Licensure]. . .became a mission of mine. . .especially since Engler was no longer [going to be] governor. I felt we had an 66 Opportunity to make that happen. So, when I started, [licensure] was a primary goal” (in- person interview, organization in support, December 13, 2007). During the 2002 gubernatorial election, representatives of MI-NASW interviewed candidates to evaluate their position on social work licensure. Granholm committed to sign a social work licensure bill if it arrived on her desk. A representative of an organization stated, We brought in candidates to meet with the [MI-NASW] board. . .There was a range of willingness to commit to support [licensure]. Through this process, we recommended endorsing Jennifer Granholm. ..She had indicated if a social work licensure bill came to her desk that she would sign it (in-person interview, organization in support, November 15, 2007). With the transfer of social work regulation from the Occupational to the Public Health Code and the election of a new governor supportive of licensure, SB. 0189 of 2003 was introduced in the Senate and referred to the Committee on Health Policy (see Figure 1). The bill was co-sponsored by Republican Senators Hammerstrom (District 17) and Goschki (District 32) and Democratic Senators Emerson (District 27), Clark— Coleman (District 3), Leland (District 5) and Jacobs (District 14). MI-NASW organized meetings to align groups in support of SB. 0189 of 2003. These discussions included the membership of MI-NASW, MI Psychiatric Association, MI Psychological Association, Michigan Health and Hospital Association, and the Michigan Association of BSW Educators. A representative of an organization in support stated, The first step was really talking to a number of people...I spent a lot of time talking to[the] lobbyist. . .I spent a lot of time trying to hear the 67 history and trying to get a sense of what members and social workers wanted (in-person interview, organization in support, December 13, 2007). Another representative of an organization in support, We developed a very close working relationship with ...Michigan Psychiatric Association and the Michigan Psychological Association. They had no opposition to what we were planning to do (in-person interview, organization in support, September 21, 2007). MI-NASW staff and lobbyists met regularly with legislators, House and Senate Committees, and representatives of the Department of Community Health as well as other public officials and representatives of private agencies. A representative of an organization in support stated, “[MI-NASW lobbyist] had a good relationship with the department and a long history of working with social welfare issues; ...he lobbied the Department through the Governor’s office” (in-person interview, organization in support, September 11, 2007). When SB. 0189 of 2003 was introduced, the MI Association of Marriage and Family Therapists and MI Counseling Association aligned in their opposition on the language of the legislation. The MI Association of Marriage and Family Therapists opposed the expanded scope of practice for the BSW and MSW. A representative of an organization in opposition stated, Senate Bill 189 allows both the bachelor’s social workers and master’s social worker to provide services to couples and families. However, the bill does not require either category to obtain any coursework or 68 experience in marriage and family therapy (David M. Bergman, personal communication, December 8, 2003).20 Both groups opposed the legislation because it permitted the licensing of the BSW and granted the bachelor level social worker a scope of practice that was “not appropriate and confusing for Michigan citizens and consumers” (Gary H. Bischof, personal communication, February 2, 2004).” The United Auto Workers also joined in opposition to 8B. 0189 of 2003. The United Auto Workers, an international labor union, represented employees of the state of Michigan-10,000 of which were employees of the Department of Human Services and impacted by the licensure of the BSW. The primary objection to licensure was concern over the loss of jobs by employees with seniority in the DHS system. It was the intent of the UAW to achieve an exemption to licensure for all public employees as was done in other states (see Table 15). The Legislative Coordinator for the UAW lobbied legislators and provided a number of position papers to both the House Health Policy Committee and House Republican Policy Office. A position paper of August, 2003 to Republican Representative Ehardt (District 83), Chair of the House Health Policy Committee stated, UAW Michigan CAP continues to have concerns about Senate Bill No. 0189 (S-l) as it passed the Senate with regards to the negative impact upon and probable job loss for thousands of members. Our primary concerns have to do with proposed licensure of bachelor’s of social work. 20Ibid. David M. Bergman was President of the American Association of Marriage and Family Therapists. The letter was written to Martha Bristor, President of the Michigan Chapter. 2|Ibid. Email communication. Gary Bischof was President-Elect of the MI Association of Marriage and Family Therapists. Email was sent to Representative Ehardt, Chair of the House Health Policy Committee. 69 We believe there is no clear purpose to license this level of social work. Instead, it should continue to be voluntary registration as it is now. Additionally, licensure of the bachelor’s of social work will do little, if anything, to further promote safe and competent care for the Michigan public. Because, the duties listed in the scope of practice at this level of practice are so broad and vague. (Nadine Nosel, personal communications, August 25, 2003).22 Table 15 States that License Social Work and Exemptions States that License the BSW State Exemptions for Public Sector Alabama, District of Columbia, Hawaii, Hawaii, Idaho, Illinois, Louisiana, Idaho, Indiana, Kansas, Maine, Massachusetts, Minnesota, Montana, New Massachusetts, Minnesota, Mississippi, Jersey, New York, North Carolina, Missouri, New Mexico, North Dakota, Pennsylvania, Texas, Alabama, Arkansas, Oklahoma, South Carolina, Texas, and Delaware, Kentucky, Missouri, New West Virginia Mexico, Oklahoma, South Carolina, Vermont, Colorado, Connecticut, Florida, Kentucky, North Dakota, South Carolina, West Virginia, and Wisconsin Source: Nadine Nosel, personal communication, August 25, 2003.23 22Ibid. 23Ibid. 70 In a position paper to the House Republican Policy Office in November, 2003, the representative of the United Auto Workers stated, “Again, the UAW supports an exemption that would exempted] public employees . This is done in many states that have licensure requirements similar to what is being proposed in Michigan by this bill” (Nadine Nosel, personal communication, November 20, 2003).24 In a final position paper to the House Health Policy Committee, a representative of the UAW again stated concerns, [The] UAW still has concern with the H-3 version of the bill. These concerns are in three areas: the very general definition of ‘social work values, principles and techniques’ ...; the all-encompassing scope of coverage for the master’s ‘macro level of social work’. ..; and, finally, the cost to public employees who will be required to replace existing staff and/or hire additional staff to fulfill the requirements of this licensure bill (Nadine Nosel, personal communication, January 20, 2004).25 The Economic Alliance of Michigan, a statewide business-labor coalition, was also in opposition to SE. 0189 of 2003. In a letter to Senator Hammerstrom, Larry Horwitz, President, stated Opposition to the legislation based on the following: SB 189. . .would license social workers who do community organizing. . .Difficulties [with] ...State implementation of a new licensure category, especially if it is so broad-based as to include people at the Bachelor’s level...[opposition to the] grandfathering clause,... [and] 24Ibid. 25Ibid. 71 education requirements for a master’s level social worker. . .licensed to perform psychotherapy services do not seem to go as far as the bill would otherwise indicate as its intent (Larry Horwitz, personal communication, May 14, 2003).26 A representative of an organization in support reported that the MI Association of Community Mental Health Boards was supportive of SB. 0189 of 2003. However, the Association expressed its concerns regarding social work licensure. The representative stated, [The CMH] system is heavily reliant on social workers, both at the bachelor’s and master’s level. Yet, [there were] issues with the bill and particularly issues around the defining of the scope of practice and the potential restrictions that the scope of practice might have for individuals who were working in the mental health system who didn’t have either a bachelor’s or master’s level credential. ...With the last of the bills, Hammerstrom’s bill, ...those issues were finally addressed in a way that were acceptable and didn’t propose workforce issues to the Community Mental Health System (in-person interview, organization in support, November, 20, 2007). Another representative of an organization in support reported, Yes, [MI Association of Community Mental Health] supported social work licensure]. We had no objections to a social work licensure bill and in fact, we were supportive of the bill in 2004. In 1990, there were a 26Ibid. 72 number of elements of the bill which we found most objectionable. . .So, we had no alternative but to oppose the bill [1990] as written but we had no objections to licensure as such (in-person interview, organization in support, November 27, 2007). The Michigan County Social Services Association was also identified as supportive but also expressed concerns over S. B. 0189 of 2003 (Stutzky, 2004). An email was sent to Senator Hammerstrom from Ellen Speckman-Randall, a representative of the organization. Ms. Speckman-Randall stated, The substitute bill for social work licensure has most, if not all, the same problems as the original bill. I don’t know how you are going to be able to develop a protected scope of practice for the bachelor’s social worker. ...Additionally there is no exception for government employees as there is in the statue for every other state... (Ellen Speckman-Randall, personal communication, July 1, 2003).27 Despite the opposition to the legislation, SB. 0189 of 2003 was passed by the Senate and House, referred to the Governor, and signed into law as MI PA 61 of 2004. A representative of an organization in support remembered the day when he stated, We earned being first in line. . .I was invited when the law was passed to be present when Granholm signed it. I. . .think is a very good bill, probably one of the best in the country (in-person interview, organization in support, September 20, 2007). 27 Ibid. 73 Summary Over the 14-year period, representatives of M]-NASW in consultation with Capitol Services, Inc. worked with the legislative, executive and administrative branches of government to pass a social work licensure bill. In the late 1980s, the leadership of MI-NASW committed to develop and implement a legislative strategy to pass licensure. Using the strategy developed by the organization, bills introduced between 1990 and 1993 were co-sponsored and supported by both Democratic and Republican leadership in the House and Senate. Bi-partisan support of the bills acknowledged that licensure was a responsibility of government for the purpose of protecting the public. However, the election of a new governor in 1991 introduced an ideology opposed to licensure as an infringement on free market forces. In response to the new administration’s position, Republican Senator John Pridnia (District 36), Chair of the Senate Health Policy Committee, intervened with the Engler Administration to determine their willingness to compromise on licensure. An agreement was brokered with SB. 0167 of 1993 to transfer social work licensure from the Occupational to the Public Health Code.28 However, MI- N ASW pulled its support of the bill due to compromise language to exclude the BSW from licensure. The goal of MI-NASW was to license the whole profession. 28The election of Engler ushered in a period of intense conflict in the bi-partisan political environment of Michigan. Compromise was the exception. The intervention by Senator Pridnia was significant to the eventual passage of social work licensure with the introduction of SB. 0167 of 1993. Senator Pridnia alerted supporters of licensure to the willingness of the administration to transfer social work regulation to the Public Health Code. Although the bill was not successful due the Objections of mental health and health organizations, social work was eventually transferred to the Public Health Code with the passage of SB. 0657 of 1999. This transfer positioned licensure for passage with the election of a new governor. 74 The language to exclude the BSW was offered by the Governor’s Office due to the opposition of the Department of Mental Health, Bureau of Occupational and Professional Regulation and the MI Association of Mental Health Boards. These organizations objected to the licensure of the BSW claiming increased costs and the exclusion of other bachelor level degrees from employment. M’I-NASW continued its efforts to maintain licensure on the legislative agenda with the introduction of H.B. 4813 of 1995, H.B. 4274 of 1997 and SB. 0657 of 1999 that transferred licensure from the Occupational to the Public Health Code. MI PA 11 of 2000 positioned social work licensure for passage with the election of a new governor. With the election of Jennifer Granholm, the leadership of MI-NASW again applied its legislative strategy with identification of a powerful Senate leader to co-sponsor SB. 0189 of 2003-Republican Senator Beverly Hammerstrom (District 17), Senate Majority Leader and Chair of the Senate Health Policy Committee. Senator Hammerstrom was joined by co- sponsors of both parties. In the House, Republican Representative Steven Ehardt (District 83), Chair of the House Health Policy Committee, was in support of the bill. The most significant opposition to SB. 0189 of 2003 was the United Auto Workers who objected to the licensure of the BSW. Despite negotiations with Governor’s office and MI-NASW and the inclusion of compromise language in the bill regarding the BSW as voluntary, the UAW remained in opposition falling short of its goal to exempt public employees. However, opposition by UAW to 75 the bill subsided. Senate Bill 0189 of 2003 passed the House and the Senate29 and was Signed into law as MI PA 61 of 2004. 29SB. 0189 Of 2003 passed the House with 98 yeas, 8 nays and the Senate with 37 yeas, 0 nays, 1 excused and became MI PA 61 of 2004. 76 CHAPTER 5 FINDINGS This chapter provides a review of the findings of the study. The data is examined to interpret the influence of advocacy groups, policy monopolies and other critical events on the passage of MI PA 61 of 2004. The findings are presented using the criteria: scope of the policy making community; changes in institutional Structure; and, other critical events. Scope of the Policy Making Community: MI PA 61 of 2004 Groups, Organizations, and Public Officials in Support of Licensure Groups, organizations and public officials in support of SB. 0189 of 2003 include the following (see Appendix S for a description of each group): 0 MI-National Association of Social Workers 0 MI-Association of Bachelor of Social Work Educators 0 MI-Association of School Social Workers 0 MI Schools of Social Work 0 MI Psychiatric Association 0 MI Psychological Association 0 MI Health and Hospital Association 0 MI Association of Community Mental Health Boards 0 AuSable Community Mental Health 0 MI Federation for Children and Families 0 MI Catholic Conference 0 MI County Social Services Association 77 0 MI Association of Counties 0 MI Department of Community Health/Granholm Administration 0 MI Department of Consumer and Industry Services 0 MI Board of Social Work 0 House Republican Policy Office 0 Democratic Representative David Gubow, District 35 0 Republican Senator John Pridnia, District 36 0 Republican Senator Dale Shugars, District 21 0 Republican Representative Stephen Ehardt, District 83 0 MI House Health Policy Committee 0 Republican Senator Beverly Hammerstrom, District 17 0 MI Senate Health Policy Committee 0 Democratic Governor Jennifer Granholm The leadership of MI-NASW in consultation with Capitol Services, Inc. was identified as significant to the implementation of the legislative strategy that maintained licensure on the agenda and resulted in the passage of the bill. MI-NASW asserted its influence to educate legislators, align groups in support and mobilize its membership. According to a representative of an organization in opposition, ...MI-NASW. . .was the driving force to keep the issue of licensure out there...as part of an ongoing [legislative] agenda. . .The organization and its staff were involved and included the entire membership of the organization. . .(in-person interview, organization in Opposition, September 21, 2007). 78 Groups and organizations representative of the health professions were also identified as significant to the support of bill. These groups maintained on-going relations with legislators and were effective in mobilizing their membership to influence policy. These groups were represented by MI Psychiatric Association, MI Psychological Association, MI Health and Hospital Association and the MI Association of Community Mental Health Boards. According to a representative of an organization in support, “. .. [Legislators] were impressed that both the MI Psychiatric Association and the MI Psychological Association were supportive of the legislation... [There was] a general cohesiveness within. . .the medical and mental health communities” (in-person interview, organization in support, November 20, 2007). Opposition of licensure by any one of the health and mental health organizations could have been problematic for passage of the legislation. According to a representative of an organization, “. . .The one thing about licensure bill is that if enough confusion is created, you loose. . .Legislators will simply wash their hands of it at some point” (in-person interview, organization in support, September 19, 2007). Finally, bi-partisan support by powerful legislators in the House and Senate was important for the success of the legislation. This was particularly significant at the time of the election of a new Democratic governor when both the House and Senate were under Republican control. In this situation, it was not enough to have the support of the Democratic governor. It was important to establish bi-partisan support in order to deliver the bill to the Governor’s desk. According to a representative of an organization in support, “. .. One of the pieces of legislation that the [Governor] had committed to sign. . .was social work licensure. .. [the Governor] did not waiver. . .if the legislation got 79 on her desk, she would sign it” (in-person interview, organization in support, November 19, 2007). Groups, Organizations, and Public Oflicials in Opposition of Licensure Groups, organizations and public officials in opposition to SE. 0189 of 2003 include the following (see Appendix S for a description of each group): 0 United Auto Workers 0 MI Association of Marriage and Family Therapists 0 Economic Alliance of Michigan 0 MI Association of Mental Health Counselors 0 MI Association for Adult Development and Aging 0 MI Association of Humanistic Education 0 Bureau of Occupational and Professional Regulation/Department of Commerce/Engler Administration30 0 Department of Community Health/Engler Administration 0 Republican Governor John Engler The most significant opposition to SB. 189 of 2003 was the United Auto Workers. This organization was synonymous with the Democratic Party in Michigan. Supporters expressed concern regarding the effect their opposition might have on the commitment of the Governor to support the bill as well as Democratic supporters in the House and Senate. According to a representative of an organization, 30The Engler Administration left office with the election of Granholm in 2002. However, they are included for their opposition of licensure throughout the 19903. 80 The United Auto Workers is strong among Democrats which we had always considered to be our core group of supporters. We only had to get a few Republicans [in order to move] a lot of those Democrats to [pass the bill]. ...Frankly, [their opposition] made it very difficult for us (in-person interview, organization in support, September 10, 2007). Changes in Institutional Structure: MI PA 61 of 2004 Alignments and Activities of Groups, Organizations and Public Ofiicials in Support and Opposition The primary coalition in support of social work licensure from 1990-2004 included: MI-NASW in consultation with Capitol Services, Inc.; MI Psychiatric Association; MI Psychological Association; and, Department of Consumer and Industry Services. When SB. 0189 of 2003 was introduced other groups joined the primary coalition in support and included the Michigan Association of BSW Educators, Michigan Association of Community Mental Health Boards and the MI Health and Hospital Association. These alignments strengthened the coalition for its representation of other social work, health and mental health professionals. This alignment was a powerful coalition with the introduction of SB. 0189 of 2003, particularly for its inclusion of the health and mental health organizations. For example, the MI Health and Hospital Association, that routinely opposed licensing bills, shifted to support the legislation. A representative of the organization stated, “They had been opposed, the Association had been opposed not just to social work licensure but to licensing bills in general” (in-person interview, organization in support, November 19, 2007). Their rationale for opposition to licensure was predicated on the 81 belief that health facilities were monitored by external accreditation organizations and therefore accountable to the consumer through their own quality assurance systems. However, the Association was asked by David Hollister, Director of Consumer and Industry under the Granholm Administration, to assist in developing criteria to assess requests for licensure. A representative of an organization in support of licensure stated, They [Department of Consumer and Industry Services] sent a letter to my boss, president of the Association, asking for help in determining criteria for which to consider health profession licensure or registration to help the Department make it less a political process and more of a public policy process. ...When Granholm came into office, the floodgates were Opened. The first couple of years we looked at 12-14 registration or licensing bills. (in-person interview, organization in support, November 19, 2008). The Michigan Health and Hospital Association did assist the Department in the development of criteria that assessed the worthiness of such requests. Each licensure bill was evaluated as to each of the following criteria: (a) the risk or harm to the public that may result without regulation; (b) the training and skills required for practice; (c) the level of autonomous practice; ((1) the scope of practice; (e) the economic impact with or without regulation; and, (f) the alternatives to ensuring public safety without state regulation (Michigan Department of Consumer and Industry Services, 2003). The criteria were also utilized by the MI Health and Hospital Association to evaluate their own rationale for the support or opposition of a number of licensing bills. As a result, in a letter to the Director of Consumer and Industry Services from Spencer Johnson, President, the MI Health and Hospital Association stated its position as follows: “The 82 MI-IA supports licensure of social workers,. . .audiologists and. . .registration of respiratory therapists” (Spencer Johnson, personal communication, September 23, 2003).31 Also, The M1 Association of Community Mental Health Boards was in opposition to social work licensure during the early 1990’s. A representative of an organization in support indicated that “Community Mental Health [during the early 1990’s] came out in opposition. I recall that the biggest issue [was related to their ability] to employ people” (in-person interview, September 20, 2007). However, they did shift to support SB. 0189 of 2003 despite their concerns due to the sponsorship of Senator Beverly Hammerstrom, a long time advocate for mental health services. According to a representative of an organization in support, Hammerstrom’s sponsorship influenced the decision of the MI Association of Mental Health Boards to support the bill. The representative stated, “. .. Certainly, the leadership of Bev Hammerstrom, having worked very hard and diligently with the mental health community on advocacy issues, helped to gain the [support of the MI Association of Mental Health Boards]” (in-person interview, organization in support, November 19, 2007). The primary coalition in opposition of SB. 0189 of 2003 included the United Auto Workers, Michigan Association for Marriage, and Family Therapists and Michigan Counseling Association. Other opposition to licensure throughout the 19903 consisted of the Engler Administration, representatives of the Department of Community Health and the MI Association of Mental Health Boards as well as representatives of the mental health agencies they represented. 31See Appendix F, Documents 83 The United Auto Workers was new to the issue of social work licensure. They were not on the record as either in support or opposition of licensure until the legislation was introduced. At that time, the UAW became a vocal and powerful opponent representing employees of the Department of Human Services. To negotiate the issues, meetings were orchestrated from the Governor’s office with representatives from Opposing groups to develop language acceptable to all parties. A representative of an organization in support stated, “I would say that the UAW, in my opinion held the strongest Opposition. ...I held meetings in the Governor’s Office between the union and the association [MI-NASW] trying to obtain a meeting of the minds on the issues” (in- person interview, organization in support, November 19, 2007). Despite the compromise to include language for the LBSW as voluntary, the UAW remained in opposition to the legislation falling short of its goal for an exemption. However, the opposition of the UAW subsided when it became clear that the Governor was firm in her support. A representative of an organization in support stated, “. .. I don’t believe they [UAW] came out in support”, but I definitely know they were no longer Opposed” (in-person interview, organization in support, November 19, 2007). The voluntary LBSW for public employees specifies that a license is required if the individual in their employment is performing all four functions of the scope of practice within the context of social work values, ethics, principles and skills. The functions include (MI PA 61 of 2004): (i) The application of social work theory, knowledge, methods, and ethics to restore or enhance social, psychological, or biopsychosocial functioning of 32The legislative record indicates that the UAW was opposed to the legislation. 84 individuals, couples, families, groups, organizations, or communities, with particular attention to the person-in-environment configuration. (ii) Social work case management and casework, including assessments, planning, referral, and intervention with individuals, families, couples, groups, communities, or organizations within the context of social work values, ethics, principles, and skills. (iii) Helping communities, organizations, individuals, or groups improve their social or health services by utilizing social work practice skills. (iv) The administration of assessment checklists that do not require special training and that do not require interpretation. The negotiations for inclusion of the language for LBSW as voluntary did not include the Michigan Association for BSW Educators. This group was a long time advocate for the LBSW. MI-NASW began to meet regularly with M1 Association of BSW Educators in 1996 (MI—NASW, 2005). Representatives of the MI Association of BSW Educators were involved in ongoing meetings regarding licensure and provided language to clarify the scope of practice for the LBSW (Bowden, personal communication, December 7, 2003).33 According to a representative of an organization in support, ...MI-NASW basically cut a deal with the UAW. There was licensure [for the BSW], but you didn’t have to get a license. . .and places could still hire people at the bachelor’s level and they didn’t have to be BSW’S. However, 33See Appendix F, Documents 85 what we did get was protection of the title (in-person interview, organization in support, December 3, 2007). The MI Association for Marriage and Family Therapists was in opposition of social work licensure in the early 1990’s. When SB. 0189 of 2003 was introduced, representatives of MI-NASW met with a representative of MI Association of Marriage and Family Therapists. The Association agreed to support the bill in exchange for support from MI-NASW regarding changes to their regulatory law. However, MI-NASW could not agree to support such changes in that the MI Psychiatric Association and MI Psychological Association were in opposition. As a result, in the last days of hearings on the bill, a letter opposing social work licensure was sent from the national office of the American Association of Marriage and Family Therapists to the president of the Michigan chapter, Martha Bristor, with a copy to Senator Hammerstrom. The letter cited three areas of concerns for their opposition. The letter stated: [The Association] “is very concerned that the legislation does not provide sufficient protection for the public... [concerned about] the practice rights provided to licensed bachelor’s social worker. . .and, the grandparenting components” of the bill (David M. Bergman, J .D. personal communication, December 8, 2003).34 According to a representative in support, .. A day or two before the hearing when they [were ready to] record the bill out. . .people from the Marriage and Family Association went into a committee meeting [in opposition]... People had been working on this and suddenly they came in last minute. . .They got a ...strong reaction from 3"Ibid. 86 committee members” (in-person interview, organization in support, November 20, 2007). As a result of their last rrrinute objections, the concerns of the MI Association of Marriage and Family Therapists were not addressed. Changes in Policy Venue Over the 14-year period, there were three identifiable changes in policy venues that influenced the passage of SB. 0189 of 2003. A policy venue is an “institutional location where authoritative decisions are made concerning a given issue” (Baumgartner & Jones, 1993, p. 32). These shifts in policy venue included: (1) Governor Engler’s decision in 1991 to transfer responsibility for social work regulation from the Department of Licensing and Regulation to the Bureau of Occupational and Professional Regulation in the Department of Commerce and to concentrate all final decision-making on licensure in the Governor’s office; (2) The action by the Board of Social Work Examiners to use their authority as a regulatory board to re-write the administrative rules for social work registration in 1992; (3) The passage of the SB. 0657 of 1999 that transferred the regulation of social work registration from the Occupational to the Public Health Code. Following the election of John Engler, Senator Pridnia inquired as to the administration’s position on social work licensure. In a letter to Senator Pridnia, the Governor stated, 87 The Bureau of Occupational and Professional Regulation (BOPR) in the Department of Commerce is now responsible for reviewing possible threats to public safety pertaining to the regulation of professions and occupations. All final determinations on changing existing standards will be made by the Executive Office based on reviews (John Engler, personal communication, October 16, 1992).35 It was also during this period that the Board of Social Work Examiners held public hearings to review and rewrite the rules for social work registration (MI-NASW, 2005). According to a representative of an organization in support, We were able to write stronger rules for registration that kept people from registering without the [education and experience]. . .NO one, probably for 10 years or more, with another degree could get registered as a certified social worker without the master’s in social work (in-person interview, organization in support, September 10, 2007). Changes to the rules eliminated certain work experiences such as a practicum or internship as qualifying experiences for certification. The new rules also defined social work and included a list of work experiences and employment that were not social work, and therefore did not allow the individual to become registered. Finally, the supervision standard for certification was changed to require supervision by a certified social worker (Arasim & Tyszkiewicz, 1999). These administrative rules were instituted despite the objections of the community mental health agencies. In a letter to Jim Haveman, Director of the Department of 35Ibid. 88 Community Health from Chris Thompson, Executive Director of J ackson-Hillsdale Community Mental Health Board, Dr. Thompson opposed the rules on behalf of the community mental health system. He stated, It appears that the Bureau, with a definition of scope of practice in rule has developed a growing list of what they believe is gilt social work as related to both experience and current employment. . .I currently have 18 staff who are attempting to obtain registration as a social worker technician or registered social worker... [who are unable to be registered] (Chris Thompson, personal communication, September 28, 1993).36 SB. 0657 of 1999 transferred the regulation of social work from the Occupational Code to the Public Health Code. Governor Engler signed the bill into law as MI PA 11 of 2000 on March 8, 2000 (see Appendix S). According to a representative of an organization in support, We felt that [transfer to the Public Health Code] took us several steps closer to our goal [licensure]. Publicly, we talked bout the fact that it would enable social workers to have the same staff handling their regulation that handled psychologists, marriage and family therapists, rather than plumbers and electricians. This was a better fit. It was also true that it would take care of several things that we didn’t have to address when we dealt with social work licensure. They’d be in the right code (in- person interview, organization in support, November 15, 2007). 36Ibid. 89 In summary, the transfer of social work regulation to the Bureau of Occupational and Professional Regulation in the Department of Commerce as well as a concentration of the decision making regarding regulation in the Governor’s office acted as a barrier to licensing over the 14-year period. The decision to re-write the administrative rules that regulated social work by the Board of Social Work Examiners along with the transfer to the Public Health Code positioned social work for licensure in the future. Other Critical Events: MI PA 61 of 2004 Election of the New Governor The election of Jennifer Granholm was identified by participants as a critical event in the passage of social work licensure. Of the participants interviewed, the majority referenced Governor Granholm’s election as a significant factor in the passage of MI PA 61 of 2004. A representative of an organization in support stated, We set up several meetings with her [Granholm] while she was campaigning to talk about the need for social work licensure. She was already an advocate for human services and did understand the professional role of the social worker. We were moving towards endorsing her trying to engage her in making a commitment to licensure. She did... (in-person interview, organization in support, January 23, 2008). As a result of her commitment, Granholm received the endorsement of the Michigan Political Action for Candidate Election. M-PACE is the political action committee of MI-NASW. A representative of an organization in support stated, She [Granholm] announced her candidacy during Legislative Day in front of social work students, faculty from the schools of social work and 90 leaders of MI-NASW. We were all right behind her, ready to campaign and vote for her (in-person interview, organization in support, September 19, 2007). A representative of the Governor’s Office stated, “their [Granholm’s office] legislative liaison made it very clear that there was going to be a social work licensure bill” (in-person interview, organization in support, November 15, 2007). Another representative of an organization in support stated, One Of the pieces of legislation that she [Governor Granholm] had committed to sign and was ready to sign if it got on her desk was a social work licensure bill. That was something that she had committed to during her campaign (in-person interview, November 19, 2007). Participants in opposition of the legislation were also aware of the commitment made by Granholm to support licensure. A representative of an organization in opposition stated, “When Governor Granholm was elected after 12- years of Governor Engler, it created the opportunity to move from registration to licensure. It was my understanding that [Governor Granholm] made a commitment to MI-NASW [to support licensure]” (in-person interview, organization in Opposition, September 21, 2007). Granholm was identified as sympathetic to the situation of social work regulation and a strong supporter of human services. A representative of an organization in support stated, “She was sympathetic from the start. [Granholm] understood that social workers missed the first transfer [of health professionals] to the Public Health Code and because of the [election of Engler] had been barred from [licensure] for a long time” (in-person 91 interview, organization in support, September 10, 2007). Another representative of an organization in support indicated, She [Granholm] has always been a strong supporter of human services. You look at what issues are her bottom line in budgets. Healthcare for the poor has always been at the head of the list. So, I think she realized that social workers work with many people who are very disadvantaged (in- person interview, organization in support, November 15, 2007). Another representative of an organization in support attributed her support to an understanding of social work associated with the fact that her sister-in-law is a social worker. The representative stated, We have a Governor whose husband’s youngest sister is a social worker. So, I think Granholm understands more about the profession. . .and the importance of making sure that we have well-educated, well—trained, highly accountable people out there in the profession (in-person interview, organization in support, September 21, 2007). Bi-Partisan Support Bi-partisan sponsorship and support were also critical factors in the success of the legislation. Throughout the 14-year period, both Republicans and Democrats supported the legislation as evidenced by: Republican Senator John Pridnia’s sponsorship of SB. 0617 of 1993; Democratic Representative Gubow’s sponsorship of H.B. 4274 of 1997; Republican Dale Shugars’ and Democratic Senator Bertrand Leland’s co—sponsorship of SB. 0657 of 1999; and, the co-sponsorship of SB. 0189 of 2003 by Republican Senator 92 Beverly Hammerstrom and Democratic Senator Bob Emerson and other representatives from both parties. Senator Hammerstrom was specifically identified as critical to passage of the SB. 0189 of 2003 because of her key position as Chair of the Senate Health Policy Committee and Majority Floor Leader. A representative of an organization in opposition stated, “She [Hammerstrom] knew how to bring the parties together from both sides of the aisle and work with the groups that were there” (in-person interview, organization in opposition, September 21, 2007). Hammerstrom was also well respected for her long time support of health and mental health issues as a member of both the House and the Senate. A representative of an organization in support indicated, Senator Hammerstrom worked very hard and diligently with the [health] and mental health community prior to the introduction of the licensure legislation and this helped. . .Senator Hammerstrom conveyed leadership and compassion in the process. She was not only someone who sponsored the legislation, but actually wanted to make sure the legislation got done (in-person interview, organization in support, November 19, 2007). The significance of Hammerstrom and bi-partisan support of the legislation was crucial according to a representative of an organization in support. She stated, We wanted a bi-partisan bill. Senator Hammerstrom had been very strong in mental health issues for a long time. She was one of the key people who understood mental health and the importance of social work as a profession. She was a highly respected Republican Senator, respected by 93 the Community Mental Health Boards, and well respected by the social work profession (in-person interview, organization in support, December 13, 2007). Legislative Day Legislative Day was repeatedly referenced by participants as influencing the process and identified as a critical event related to the successful passage of the bill. Legislative Day was an annual event sponsored by MI—NASW and Capitol Services, Inc. in partnership with the schools of social work throughout Michigan. A representative of an organization in support stated, Social workers did their job of educating and creating a movement, including visits to the Capitol making sure that people knew who social workers were. They would hold a Legislative Day making sure their presence was known and making sure they had students of social work there (in—person interview, organization in support, November 19, 2007). Legislative Day was an opportunity for students to accompany faculty to the Capitol for instruction on the legislative process and policy issues relevant to social work. Social work licensing was a regular topic at the event and students were encouraged to contact their legislators to support the effort. A representative of an organization in support indicated, “1 had students do [letter] writing and we targeted legislators who weren’t supportive. . .We would bring in 300—400 students on Legislative Day to meet with their legislators and talk about licensing” (in-person interview, organization in support, November 27, 2007). 94 It appeared that this event was effective in mobilizing students to support the bill in that participants were consistent in remembering the event. A representative of an organization in support stated, “I think the activity of social workers on the bill for many years, both the legislative work and grassroots work, contributed to the passage” (in- person interview, organization in support, November 20, 2007). The effort to educate and mobilize students was also effective in that social work students throughout Michigan emailed Senator Hammerstrom in support of SB. 0189 of 2003. Kim Dickerson, a graduate student at Andrews University, stated in an email to Senator Hammerstrom, As I prepared to enter this honorable profession, I became aware that there were no licensing standards in place in Michigan for Social Work, nor was there an exam that one must pass before beginning practice as a social worker at any level (Michigan Senate, 2003, May 14).3'7 Another student emailed the Senator in support of macro practice licensure. Enrica Rapicano, a graduate student from Wayne State University, stated, I understand that those choosing the interpersonal concentration vastly outnumber those in the community concentration. However, we are all social workers. Even though, historically, social work began as a community effort, it has also grown to incorporate the need for therapy on an individual and group level. Please do not allow this bill to go to the House of Representatives until community practitioners are treated fairly 37Email communication to Hammerstrom contained in Michigan Senate (2003, May 14). 95 and are represented in Senate Bill 189 [of 2003] (Michigan Senate, 2003, May 14).38 Karen Hinderliter, Dana Kitchend, Gertrude Cobb, Kathleen McLogan, and Natisha Adams emailed Senator Hammerstrom in support of the bill. They stated, AS students of social work at Michigan State University’s School of Social Work, we would like to tell you how interested and excited we are in any information about this bill. We strongly support it and would like to be more active in its passage (Michigan Senate, 2003, May 14).39 Social Work Summit The Social Work Summit was a meeting regularly scheduled by MI—NASW with other social work professional organizations in Michigan. The meetings included representatives of a variety of groups, representative of a diversity of practice modalities that included the MI Association for the Advancement of Social Work with Groups, MI Association of Black Social Workers and Michigan Association of School Social Workers (see Table 16). The meetings were arranged for the purpose of discussing issues of concern to social work such as social work licensure. The Summit provided a venue for social workers to build a consensus on licensure as good for the whole profession. As a result, MI-NASW evolved as the organization that spoke for the profession on social work licensing. 38Ibid. 39Ibid. Table 16 Social Work Summit: Participants Association for the Advancement of Social Work with Groups Association of Black Social Workers MI Association of Social Workers in Health Care MI Association of School Social Workers MI Council of Nephrology Social Workers MI Hospice Social Work Association MI Society of Clinical Social Workers North American Association of Christians in Social Work Organizations of Latino Social Workers Social Welfare Action League Social Workers in Home Health Care Source: MI-NASW (2000, May 25), Social Work Summit40 that included the MI. Prior to the 19903, social workers attempted to work with the legislature to pass a social work licensure bill but experienced difficulty. The source of the difficulty appeared to be the profession’s inexperience with the legislative process. A representative of an organization in support stated, “. .. Social workers aren’t any different than anyone else in terms of their sophistication about the legislative [process . .They need] to learn” (in person interview, organization in support, September 20, 2007). 40See Appendix F, Documents. 97 When bills were introduced throughout the 19803, social workers from different practice arenas were in conflict as to the language and purpose of the legislation. Representative of an organization in support described the early attempts to pass licensure in Michigan. He stated, There were at least 10 other social work groups within the state that have been around for a long time, clinical social workers would be a good example. They and other groups would form a coalition and draft legislation. Then, we would spend most of the time arguing amongst ourselves [and testifying for and against the legislation] (in-person interview, organization in support, September 20, 2007). Another representative in support indicated, MI-NASW was not the [spokesperson] for social workers in Michigan in the beginning. This kept them from getting into the Public Health Code- nobody could agree on who spoke for social work. We tried to identify every social work group we could find and invited them to the Social Work Summit (in-person interview, organization in support, September 10, 2007). In summary, the election of a new governor, bi-partisan support of the legislation and particularly the sponsorship of a powerful and well respected legislator were significant to the success of the legislation. Legislative Day broadened mobilization efforts in support of the bill beyond the membership of MI-NASW to include students and faculty throughout Michigan. Finally, the role of the Social Work Summit in the emergence of MI-NASW as the spokesperson for the profession was critical to overcome 98 a history of divisiveness within the profession related to licensure prior to 19903. The Summit provided the platform for MI-NASW to represent the profession and to mobilize the membership in support of the legislation. Public Image: MI PA 61 of 2004 There were five perspectives identified as the public image of social work licensure over the 14-year period. Two of the images contributed to passage of the legislation while three acted as barriers to licensure. Those identified as contributing to the passage of the policy were public safety and welfare and the understanding that Michigan was the last state to license social workers. Those in opposition were identified as free market protection, restriction of services and job protection. Public Safety and Welfare The predominate view for the regulation of social work practice was to ensure that those individuals practicing social work were trained and skilled so as not to cause harm to the public. Participants were consistent in their articulation that licensing was important to protect the public from incompetent and unethical practices. Licensure was viewed as a standard of public accountability that was the responsibility of state government to establish in order to ensure that qualified people were performing the services. A representative of an organization in support commented on the criteria for evaluating the need to regulate a health profession. He stated, Let me give you a sense of the criteria [we use]...risk or harm to the consumer, specialized skills and training, [and] distinguishable scope of practice. . .Govemment regulation is unnecessary unless there is a clear threat to the public’s health or significant potential to improve quality 99 through state regulation (in-person interview, organization in support, November 19, 2007). A newspaper article in the Lansing State Journal (2003, May 8) included a story related to intent of licensure to protect the public. The article stated, Recently, the State Journal reported on a human services caseworker who pleaded guilty to sexually abusing a 13—year old boy. Now there are allegations this individual sexually abused about 20 boys during his 14- years with a previous employer. ...Stories like this vividly illustrate the need for licensure of social workers in Michigan. Michigan is one of only 2 states41 that do not license social work at any level. of professional practice (p. 17A). An article in the Detroit News (King, 2000, March 12) highlighted the need for trained social workers experienced in youth services. The article indicated, “The center is seeking two full time social workers one for its mothers-and-infants program and the other for the outreach program” (p. 01L). In summary, protection of the public from untrained and incompetent professionals is a driving force for government regulation. According to an interviewed participant, for most legislators, the “litmus test regarding any licensure bill” is the question as to whether the public was harmed by the lack of licensure (in-person interview, organization in support, September 20, 2007). 41 . . . . . . . . According to the newspaper article, there were 2 states besrdes Mrchrgan that did not lrcense social workers. However, the researcher is only aware of l state-Arizona. Licensure was passed in Arizona prior to Michigan, leaving Michigan as the last state to license. 100 Michigan as the Last State to License The understanding that Michigan was the last state to license social work was also a driving image toward licensure that impacted legislators in particular. According to a representative of an organization in support, “This issue [social work licensure] was around forever. (in-person interview, organization in support, November 20, 2007). A newspaper article in the Detroit News (Kozlowski, 2004, April 12) emphasized the circumstance of Michigan as the last state to license. The article stated, “Michigan is poised to become the last state in the nation to license social workers...” (p. 01C). A newspaper article also appeared in the Grand Rapids Press (Associated Press, 2004, April 12). The article stated, In a move aimed at boosting accountability among those who work with the state’s neediest residents, Governor Jennifer Granholm was expected to Sign a bill today requiring that social workers be licensed. . .Michigan is the last state to require social workers to be licensed (p. C4). According to a representative of an organization in support, Michigan’s time had come for licensure as the last state to license. She stated, “There was a window of opportunity and a lot of leg work had been done. . .So, I think just the timing was right.” (in-person interview, organization in support, December 13, 2007). Free Market Protection Market protection was identified as the prevailing image that acted as a barrier to passage. This perspective was well articulated by John Engler in a letter to Senator Pridnia: “When individuals are prohibited from practicing their skills or entering certain trades because of unnecessary regulatory barriers, consumers are precluded from 101 receiving the economic benefits provided by competition and free market forces” (John Engler, personal communication, October 16, 1991).42 A representative of an organization in opposition viewed licensure as an unnecessary expansion of government that enlarged bureaucracy and increased the strain and cost on departments ill equipped to monitor the regulation of any type of new licensure. He stated, When it came to licensure. . .We just said no because licensure had a way of being costly. It would grow up bureaucracy. We weren’t interested in any new bureaucracies. Licensure becomes a world of its own with a staff, passing rules, and we didn’t want any of that so we just said no (in-person interview, organization in opposition, November 2, 2007). Another representative of an organization in opposition stated, He [Engler] felt it was all about market protection and it was groups trying to protect their market and he was not going to allow it to happen. . .Engler had a very strong position. He was completely inflexible on the position. It was a free market position (in-person interview, organization in support, December 13, 2007). Restriction of Services Restriction of services was the prevailing image in opposition to licensure presented by representatives of mental health organizations and other professional groups. It was the position of these organizations that the licensing of the bachelor’s social worker restricted access for other qualified professionals to provide services thus 4ZSee Appendix F, Documents. 102 reducing services and increasing costs. A representative Of an organization in support stated, The major negative consequences [of licensure] were: First, it would have created a major shortage of available candidates by limiting people that were already working for us in disciplines [other than social work]. It would have made it difficult for us to fulfill our responsibilities because we would not be able to find people to fill the positions. Second, it would have substantially increased our costs because any time that you limit a pool, you make the individuals in the pool more valuable from an economic standpoint. Without any intent by the state to cover those increased costs, we didn’t see how we were going to do that. Finally, philosophically, we felt that it would have elevated one service profession at the expense of some others which we valued equally (in-person interview, organization in support, November 27 , 2007). Job Protection J ob protection was the prevailing image in opposition to licensure presented by the United Auto Workers. The opposition of the United Auto Workers, like the mental health organizations, was also related to the scope of practice of the bachelor’s social worker. According to a representative of an organization in opposition, the major concern of the union was the protection of the positions of its membership. The representative stated, MI-NASW was making the claim that no one would lose their job when the bill was passed. We argued that this wasn’t true. We argued that they 103 would have lost their jobs because they didn’t meet the criteria in having a social work degree to do the jobs. The bachelor’s social work degree was being required by the scope of practice that was initially in the law (in- person interview, organization in opposition, September 21, 2007). Summary Within the scope of the policy making community, the leadership of MI-NASW working with Capitol Services, Inc. was identified as significant to the achievement of social work licensure in Michigan. Throughout the 14-year period, efforts were consistent to implement the legislative strategy developed in 1989. This strategy involved the leadership of MI-NASW and their lobbyists working with the legislative, executive and administrative branches of government to influence the development of policy consistent with the goal to license the whole social work profession-BSW and MSW. Their efforts to influence were evident with the introduction of seven social work licensure bills over the 14-year period. The organization maintained licensure on the legislative agenda and used the opportunities to educate and influence legislators as to the importance of licensure for the protection of public safety and welfare as well as Michigan as the last state to license. During periods when it was evident that there was to be no licensure law due to the ideological position of the Engler administration that licensure was an infringement on a free market, MI-NASW continued to work to influence the legislative and administrative branches of government. Both the 1992 rewrite of the administrative rules regulating social work and the passage of SB. 0657 of 1999 that transferred social work regulation from the Occupational to Public Health Code were significant for positioning licensure for future passage. 104 It was also the strategy of MI-NASW to align other groups and organizations with influence on the legislature in support of licensure. In the case of MI PA 61 of 2004, the groups were identified as the MI Psychiatric Association, the MI Psychological Association, MI Health and Hospital Association, the MI Association of Community Mental Health Boards as well as the MI Association of BSW Educators and MI Schools of Social Work. The health and mental health organizations were an organized presence in the state capitol with established relationships with powerful legislators. MI-NASW engaged the Schools of Social Work and the MI BSW Educators in developing language for the legislation and worked with faculty to influence legislators and mobilize students to do the same. Within the scope of the policy making community, the most significant opposition to licensure over the 14-year period included the Engler administration, the MI Association of Community Mental Health Boards, and the United Auto Workers. Opposition on the part of the MI Association of Mental Health Boards resulted from their concern regarding the licensing of the BSW and the potential of the regulation to increase costs and restrict services. The UAW also opposed the legislation due to the licensing of the BSW as a threat to the employment of its membership. The opposition of the MI Association of Mental Health Boards subsided with the introduction of SB. 0189 of 2003. The organization believed that concerns were addressed with the licensure of the BSW as voluntary. This compromise was brokered by the Governor’s office, MI—NASW, Capitol Services, Inc. and the UAW without discussions with the MI Association of BSW Educators. The BSW as voluntary was a compromise on the part of MI-NASW whose goal it was to license the whole profession. 105 Also, the MI Association of Mental Health Boards was influenced to support the bill due to sponsorship by a loyal legislative advocate for mental health issues, Senator Beverly Hammerstrom. The UAW remained opposed to the legislation even with the inclusion of the language that defined the BSW as voluntary. However, the UAW reduced its opposition when it was clear the bill was supported by a majority of the House, the Senate, as well as the Democratic governor. The most critical event to influence the passage of the legislation was the change in the governing coalition. The Engler administration was an insurmountable obstacle to social work licensure due to its ideological position. The election of Jennifer Granholm provided the opportunity for the legislative strategy of MI-NASW, worked over the 14- year period, to achieve the goal of licensure. Granholm was a governor with an understanding of the role of social services and social work, and the importance of licensure for public safety and welfare. The election of Granholm provided the window of opportunity for the passage of the legislation. 106 CHAPTER 6 CONCLUSIONS AND IMPLICATIONS This chapter presents an interpretation of the passage of MI PA 61 of 2004 according to the ACF and punctuated equilibrium theory. Conclusions are drawn as to which of the models provides a more comprehensive understanding of the passage of the legislation. Conclusions are also drawn as to the how the models compliment one another. The significance of the research for future study of the policy change process is proposed. Implications of the research for social work policy practice are discussed. ACF: Interpretation of the Passage of MI PA 61 of 2004 Scope of the Policy Making Community According to the ACF (Sabatier & Jenkins-Smith, 1993), the scope of the policy making community was comprised of representatives of the advocacy coalitions and the legislative, executive and administrative branches of government in support and opposition. In the case of MI PA 61 of 2004, the representatives of government in support were identified as: 0 Representatives of Governor Granholm’s Office 0 Representatives of Republican Senator Hammerstrom’s Office (District 17, Chair of the Senate Health Policy Committee, Senate Majority Floor Leader) 0 Representatives of Democratic Senator Bob Emerson’s Office (District 27, Co-Sponsor of SB. 0189 of 2003) 0 Representatives of Republican Representative Elhardt’s Office ( District 83, Chair of House Health Policy Committee) 0 Representatives of the Department of Community Health 107 The primary advocacy coalition in support was comprised of the following: . MI—NASW43 0 MI Association of BSW Educators 0 MI Psychiatric Association 0 MI Psychological Association 0 MI Health and Hospital Association 0 MI Association of Community Mental Health Boards The primary advocacy coalition in opposition included: 0 United Auto Workers 0 MI Association of Marriage and Family Therapists 0 MI Counseling Association According to ACF, the primary groups in support and the elected and employed representatives of government made up the policy making community. It was the alignment and activities Of the advocacy groups working with representatives of government over the 14-year period that produced change. Institutional Structure ACF proposed that the advocacy coalitions in support and opposition would remain stable over the 14-year period held together by core beliefs (Larsen et al., 2006). MI-NASW remained committed to achieve social work licensure and worked diligently over the period to realize the goal to license the whole profession including the BSW for the health, safety and welfare of the public. The organization worked to align key groups 43In 1989, MI-NASW entered into a contractual relationship with Capitol Services, Inc., a multi-client lobbying firm, to represent them in their efforts to achieve licensure. Throughout the 14-year period, the two organizations worked diligently to implement the legislative strategy developed in 1989. 108 representing other mental health professions in support of the legislation. These included the MI Psychiatric Association and MI Association of Psychologists. These organizations joined the coalition in support of H.B. 4491 of 1991. The alignment remained stable from 1991-2003. Even with a change of leadership in 2001, MI-NASW remained committed to maintaining the alliances to prepare for the day when there would be a new governor. An alliance between MI Association of Marriage and Family Therapist and MI Counseling Association remained stable in opposition over the 14-year period. This opposition was predicated on their objections to the licensure of the bachelor’s social worker as well as the concern that the expanded scope of practice for the master’s social worker was not only an infringement on their practice, but was actually broader than their own scope of practice. However, in the case of MI PA 61 of 2004, these were the only alliances that remained stable. Groups previously in opposition moved to support. These organizations included the MI Health and Hospital Association and the MI Association of Community Health Boards. The United Auto Workers, not on the public record as either in support or in opposition prior to 2003, took a position in opposition with the introduction of SB. 0189 of 2003 due to the licensing of the bachelor’s level social worker considering it a threat to the employment of their membership. Critical Events ACF, as a theory of stability and incremental change, proposed that dynamic policy change occurred as a result of a change in governing coalition (Sabatier & Jenkins- Srnith, 1993). The change in governing coalition was identified as the election of Jennifer Granholm. 109 Summary According to ACF, the leadership of MI-NASW worked diligently with policy makers over the l4—year period. Policy learning was evident. Incremental change occurred when the Board of Social Work Examiners wrote new administrative rules for the regulation of social work in 1992, and also when social work regulation was transferred to the Public Health Code in 2000. The election of Granholm was identified as a macro condition that produced dynamic change-passage of MI PA 61 of 2004. According to ACF, it was the advocacy coalitions held together by their beliefs working over a decade or more that produced policy change. The ACF provided an interpretation of the passage of the legislation consistent with the concepts of the framework. Punctuated Equilibrium Theory: An Interpretation of the Passage of MI PA 61 of 2004 Scope of the Policy Making Community Punctuated equilibrium theory (Baumgartner & Jones, 1993) proposed that representatives of the political institutions and the public comprised the scope of the policy making community. In this case, the political institutions were represented by officials of the legislative, executive and administrative branches of government. These included: 0 Governor Granholm’s Office 0 Michigan Senate 0 Michigan House 0 Michigan Board of Social Work 110 0 Department of Community Health The public was represented by: 0 Advocacy groups in support and opposition 0 Social Work Students and Schools of Social Work According to punctuated equilibrium theory, it was the mobilization of the public that elected a new governor resulting in a change in policy. Institutional Structure Punctuated equilibrium theory proposed that institutional structures changed over the 14-year period. According to the theory, these changes occurred with the establishment of a new policy monopoly. The first example of the establishment of a new policy monopoly affecting the success or failure of social work licensure occurred with the election of Republican John Engler over Democratic Governor Blanchard. This change instituted a shift in the policy image of licensure from the protection of the public to an infringement on market forces and stalled the process for the next 12 years. However, MI-NASW mobilized to keep licensure on the legislative agenda throughout the 14-year period. During this period, the Board of Social Work Examiners strengthened the standards for social work registration. Also, it was at this time that the Engler Administration supported a change in venue moving social work registration from the Occupational Code to the Public Health Code. A3 Engler came to the end of his term, MI-NASW interviewed the gubernatorial candidates to determine their position on social work licensure. Jennifer Granholm was identified as the candidate committed to licensure and agreed to sign a bill if elected. 111 With her election and the establishment of a new policy monopoly supportive of licensure, efforts were renewed to introduce a new social work licensure bill. Critical Events According to punctuated equilibrium theory, public mobilization destabilizes the existing policy monopoly resulting in dynamic policy change with the establishment of a new policy monopoly. In the case of MI PA 61 of 2004, mobilization was demonstrated throughout the l4-year period with the alignment and activities of the groups advocating for policy change and working to elect an administration supportive of the policy. Bi- partisan support, Legislative Day, and the Social Work Summit are all identified as critical events in the passage of the legislation. Summary The advocacy groups, social work students and schools of social work mobilized to support the passage of the legislation. This mobilization was evidenced by the activities to elect a new governor as well as to advocate for passage of the policy. The mobilization resulted in the establishment of a new policy monopoly with a new image of licensure as protection of the public’s health, safety and welfare and Michigan as the last state to license. Punctuated equilibrium theory provided an interpretation of the passage of MI PA 61 of 2004 that was consistent with its theoretical concepts. According to punctuated equilibrium theory, it was the election of a new governor that produced policy change. 112 Comparison of the ACF and Punctuated Equilibrium Theory To provide insight as to which model provides a more comprehensive interpretation of the policy event, a comparison of ACF and punctuated equilibrium theory is presented. This comparison addresses: (a) facets of policy making-stability and change; (b) scope of the policy making community; (0) institutional structure; and (c) critical events. ACF is a model of policy stability. In the case of MI PA 61 of 2004, attention to incremental change informs the case, but it appears insufficient in its explanation of the macro condition-change in governing coalition-that influenced passage of the legislation. According to ACF, the scope of the policy making community was narrow and focused on the interaction of the policy elites. The model did not accommodate the mobilization of MI—NASW or the involvement of social work students and faculty through Legislative Day. ACF also proposed stability in the alignment of the groups over a decade or more to influence incremental change. The primary coalition of MI-NASW, MI Psychiatric Association and MI Association of Psychologists remained stable and committed to the licensure of social work throughout the 19903. ACF identified a change in governing coalition as a macro condition for dynamic policy change. The election of Jennifer Granholm was identified as such a critical event. Punctuated equilibrium is a theory of stability and dynamic policy change. In the case of MI PA 61 of 2004, the theory provides the theoretical foundation to interpret both facets of the policy making process. Punctuated equilibrium theory proposed that representatives of the political institutions and the public comprised the scope of the policy making community. Punctuated equilibrium theory broadened the policy making 113 community beyond the policy elites. According to punctuated equilibrium theory, institutional structures changed over the 14-year period. These changes were influenced by mobilization of the stakeholders that produced a new policy monopoly with the election of a new governor. In contrast to the ACF, punctuated equilibrium theory identified the mobilizing activity of the advocacy groups as significant to the election of the governor rather than a macro condition external to the policy system. Punctuated equilibrium theory also incorporated an understanding of the critical events evident in the case of MI PA 61 of 2004. Through the concept Of mobilization, punctuated equilibrium theory allowed for an interpretation as to how the mobilizing activities strategized by the leadership of MI- NASW in consultation with Capitol Services, Inc. influenced and provided a foundation for understanding the role that Legislative Day and the Social Work Summit played in the passage of the legislation. Public mobilization was interpreted as the involvement of groups and their membership in policy advocacy and electoral politics. Policy advocacy was defined as mobilizing efforts to influence legislators through emails, letters and other forms of contact (J ackson-Elmoore, 2005). Electoral politics (Hermson, Stokes-Brown & Hindman, 2007; Jackson-Elmoore, 2006) was defined as efforts to support and campaign for the election of a gubernatorial candidate supportive of licensure. Punctuated equilibrium theory provided a framework for interpreting how the mobilization of the membership of MI-NASW contributed to the establishment of a new policy monopoly supportive of licensure. 114 Punctuated equilibrium theory also provided a framework for understanding the role that the Legislative Day and Social Work Summit played in the passage of the legislation. The mobilization of social work students through Legislative Day broadened the scope of the policy making community and energized the momentum toward licensure. The Social Work Summit was directed toward engaging and mobilizing other social work groups without a defined relationship or identify with MI-NASW to view the organization as the spokesperson for licensure (Jackson-Elmoore, 2005; 2006). Certainly, these events are related to the election of the Governor. However, they were significant unto themselves as mobilizing activities-political in nature-for the recognition of the power of MI-NASW as spokesperson and the grass roots power of students to affect institutional and policy change (J ackson-Elmoore, 2005; 2006; Kiibler, 2001). Thus, it is concluded that punctuated equilibrium theory provided a more comprehensive interpretation of the passage of MI PA 61 of 2004 when compared to ACF. The scope of the policy making community, change in institutional structure and critical events throughout the 14-year period supported the influence of policy monopolies and mobilization on stability and change. Complimentary Nature: ACF and Punctuated Equilibrium Theory It is suggested by the researcher that ACF and punctuated equilibrium theory complimented one another in regard to the interpretation of the case. ACF provided an understanding of the influence of the primary coalition lead by MI-NASW on policy change; while, punctuated equilibrium provided an understanding of how the election of a new governor resulted in the passage of the legislation. 115 ACF’s emphasis on the alignments and activities of the advocacy groups provides a framework for understanding the significance of group membership and resources on policy change. Furthermore, the framework accentuates the commitment to core principles as the prime motivator of the advocacy groups to persistently hold coalitions together and work to accomplish the goal. However, ACF does not provide a conceptualization of how these alignments and activities demonstrate the use of their resources and power to impact institutional change. Rather, it assumes that policy learning occurs and that policy change is incremental as a result of the alignments and beliefs of the groups. On the other hand, punctuated equilibrium theory acknowledges the importance of mobilization on institutional change and policy change. However, the theory is limited in its presentation as to the influence of group membership, resources and power on the efforts and effects of mobilization (Walker, 1983; 1991). In other words, in order to mobilize, a group requires membership, resources and the power to organize. Also, when groups mobilize there is usually a core belief or principle that solidifies the movement. Therefore, it is suggested that in the case of MI PA 61 of 2004, that punctuated equilibrium theory is complimented by ACF for its understanding of groups and the role of core beliefs on the alignments and activities of these groups. The passage of MI PA 61 of 2004 is significant not only for its achievement of the goal to license social work, but as a case that demonstrates the applicability and compatibility of the ACF and punctuated equilibrium theory as conceptual frameworks for an interpretation of the variables influencing successful passage of a policy. Certainly, the case exemplifies the political knowledge and skill of MI-NASW in consultation with 116 Capitol Services, Inc. to achieve the goal. But, the complementary nature of the theoretical foundations also enhances an understanding of the case to contribute to policy relevant education, curriculum and practice. Social Work Implications This case study of policy change reinforces the importance of policy advocates understanding the complexity of the policy change process over time. Policy advocates require a theoretical understanding of the policy process so as to apply the appropriate skills at the appropriate time to impact policy decisions (Jackson-Elmoore, 2006). Frameworks for understanding the policy change process, like ACF and punctuated equilibrium theory, are informative for social work students (J ackson-Elmoore). Furthermore, MI PA 61 of 2004 is a case that demonstrates the expertise of the profession to form alliances, mobilize and influence policy change. The case example provides a model case study with theoretical foundations to demonstrate the ability of the profession to impact policy. Policy Practice: Value Foundation Knowledge of the policy change process contributes to social work’s historical commitment to the provision of policy informed services accessible to those in need (Colebatch, 2005; Figueira—McDonough, 1993; Gal & Weiss, 2000; Greene & Knee, 1996; Hoefer, 2005; Linhorst, 2002; Pearlmutter, 2002; Schneider & Netting, 1999; Weiss, 2003; Wyers, 1991). Today, social work is challenged to advance its mission in the context of devolution policy that contributes to an erosion of public funding for public and private social services (Gronbjerg & Salamon, 2002) and eliminates cash entitlements for families and dependent children (Schneider, 2002). As a result of such 117 policy, social work must consider policy practice as integral to the profession for its assessment of the impact of devolution on the most vulnerable of populations with whom the profession works. For social work, policy practice seeks to change policy in order to help those without power within the existing social order access resources and opportunities (Fisher & Karger, 1997; Haynes & Mickelson, 2000; Hoefer, 2006; Jansson, 2004). Therefore, it is important for the profession to broaden its theoretical understanding as to how policy changes over time for the purpose of developing policy consistent with social work’s value foundation and responsive to the needs of individuals, families and communities. Social Work Policy Practice Gal and Weiss (2000) adopt the definition of Jansson (1990) that policy practice is “the use of conceptual work, intervention and value clarification to develop, enact, implement, and assess policies” (p. 24). Social work policy practice is a social work intervention that combines direct practice and social policy and links to the mission of social work to improve individual functioning and facilitate social change to respond to the needs of individuals and communities (Greene & Knee, 1996; Linhorst, 2002; Pearlmutter, 2002; Schneider & Netting, 1999; Wyers, 1991). Policy practice is viewed, as not only a problem solving process of intervention, but also a field of practice. According to Greene and Knee (1996), practice is based on an idea that social work is a social intervention that takes social workers beyond problem solving into an active role of building social systems. Therefore, according to this perspective, it is not enough for the professions to deliver services to the client but also to create social structures that will enhance individual and social development. 118 The goal of policy practice is to provide informed services to those in need through influencing policy development, implementation and evaluation. Policy practice models are derived from practice experiences and incorporate a variety of social work roles and functions. Social workers in policy practice include social workers as policy experts, change agents and policy conduits. For the social worker, policy practice requires an understanding of the effects of policy on clients as well as responsibility to change policy detrimental to client need (Hong & Wemet, 2007; Pearlmutter, 2002: Wyers, 1991). Policy Practice Curriculum The political activity of social workers and social work students has increased over the last 30 years (Gal & Weiss, 2000; Weiss et al., 2002; Wolk, 1996). However, there is a minority of social workers in policy practice and limited training in social policy and practice in schools of social work (Gal & Weiss, 2000; Weiss, Gal & Katan, 2006). Ga] and Weiss (2000) analyzed the role of policy practice and social policy in the knowledge and practice of social workers and social work students in Israel. The findings indicated a growth in the political activity of social work students but limited curriculum content on policy practice. The authors suggested that this lack of representation may be due to the overwhelming influence of American social work related to the privatization of the Israeli welfare state. However, despite the absence from the curriculum, Gal and Weiss stated: ...there has been growing recognition that there is a need both to enhance social work students’ commitment to social change as part of the process 119 of professional socialization, and to equip students with the analytic tools and practical methods necessary in order to undertake policy-practice” (p. 487). Weiss (2003) completed a survey of 138 social work students in Israel. The research examined a model that correlated the willingness of students to participate in policy practice to the significance students’ assigned to the social justice goals of social work. Findings indicated a strong relationship between the importance that students attribute to the goals of social work and willingness to engage in policy practice. According to Weiss, . .the degree of willingness of students to engage in policy-practice increased when they attributed greater importance to society-oriented goals of social work and lesser importance to individual-oriented goals” (p. 14). A survey of students in the United States, United Kingdom and Israel found that students believe that social structures were the etiology of social problems and continued to adhere to core social work values (Weiss et al., 2002). Students surveyed agreed with the assertion that personal distress is rooted in social structures and that it was the responsibility of the state to deal with social problems and redistribute resources. Even with a long tradition of participation in the political process, social work is critiqued for its limited impact on a political agenda that eroded social welfare policy and services during the 19903 in the United States (Hamilton & Fauri, 2001; Lens & Gibelman, 2000; Reisch, 2000; Ritter, 2006; Wolk, 1996). The profession is encouraged to engage in policy practice at a time when the responsibility for social welfare has shifted from the federal to state government (J ackson-Elmoore, 2005; 2006; Schneider & Netting, 1999). According to Colebatch (2005; 2006), study of the policy change process 120 is required to inform the practitioner and provide practical theorizing. It is important for the profession to broaden its theoretical understanding as to how policy changes over time for the purpose of teaching and developing policy consistent with social work’s value foundation. Summary The findings of this research are significant for its consideration of the complementary nature of the ACF and punctuated equilibrium theory to explain a policy event. The ACF contributes to an understanding of the role groups and organizations play in the policy process. According to the ACF, it is the policy elites, sophisticated in their knowledge of the policy process, who effect change through influencing the legislative, executive and administrative branches of government. Punctuated equilibrium theory identifies the influence of mobilization producing a punctuating moment for policy change. According to punctuated equilibrium theory, it is the mobilization of the public through advocacy, electoral politics and public understanding of the issue that produces a change in the policy monopoly. These concepts construct a complimentary lens through which to consider the influence of the policy elites producing incremental change over a decade or more and the influence of mobilization and electoral politics on dynamic policy change. This complementary lens may be useful for future research to explain another policy event. The research was also significant to the social work profession for implications regarding the activity of social workers involved in policy practice and electoral politics. The research informed the profession as to the significance of participation in the policy process. Social workers in Michigan remained committed to the policy goal to pass 121 licensure in the state of Michigan over a 14-year period. MI-NASW in consultation with Capitol Services, Inc. formulated a legislative strategy that included efforts to influence the legislative and administrative branches of government and mobilized advocates waiting for the opportunity to elect a new governor supportive of licensure. This case exemplified the importance of social work’s participation in advocacy and electoral politics as a means to change policy. Consideration is also given to the implications of the research for policy curriculum. Students require both a theoretical foundation and the practical skills to participate in the policy process. The introduction of the ACF and punctuated equilibrium theory from the political science literature into policy courses provides a conceptual framework to broaden student understanding as to how policy changes. Future research may focus on the implications for social work curriculum and practice. Currently, what is the content on policy practice in schools of social work? How do schools of social work identify and mentor students interested in policy practice? Finally, the research provides practical guidance for other occupations interested in attaining professional licensure as well as social workers committed to policy advocacy and political action. To engage in the policy process, professions may consider the following guidelines: 0 Identify the policy issue within the policy subsystem 0 Research the policy issue 0 Research public understanding of the policy issue 0 Identify and align powerful groups and organizations in support 0 Identify groups and organizations in Opposition 122 0 Educate and build relationships with the legislative, executives and administrative branches of government 0 Educate and build relationships with advocates o Facilitate bi-partisan support with powerful legislators 0 Mobilize advocates c Engage in electoral politics 0 Prepare to work over a decade or more 0 Remain persistent and patient for a window of opportunity In conclusion, the legislative strategy to achieve licensure may also be applicable for the development of policies that support fair access to services and opportunities for underserved populations with whom professions work. The lesson to be learned from the research is that policy making requires participation over a decade or more in both policy advocacy and electoral politics to achieve policy change. 123 APPENDICES 124 APPENDIX A TELEPHONE/EMAIL SCRIPT 125 TELEPHONE/EMAIL SCRIPT“4 Hello, I am Jane Hayes, a Ph.D. candidate, conducting a research study examining the legislative history of MI PA 61 of 2004, Social Work Licensure. Of particular interest are the extent and nature of support or Opposition to social work licensure, as well as, the context in which the legislation was passed. This research is being conducted as my dissertation study. I am under the supervision of Dr. Cynthia Jackson-Elmoore in the School of Social Work at Michigan State University. You are identified by reputation as involved in the policy process or as organizing for the support or Opposition of the policy. Your participation will consist of a face-to- face interview of approximately 1 hour in length at a mutually agreed upon time and place. You must be 18-years old to participate in this study. The confidentiality of all participants will be ensured except in those instances when information is already public knowledge or when advance permission is given to attribute a quote. Are you willing to participate in this study? Yes No IF YES, SCHEDULE A DATE, TINIE AND PLACE. If no, is there someone from your organization who was involved in the passage of MI PA 61 that I may contact? Thank you. 4Ame State legislative Histories by C. J ackson-Elmoore, 2006, Michigan State University, IRB Exempt Study, X05-986. Adapted with permission. 126 APPENDIX B COVER LETTER 127 COVER LETTER45 Put on letterhead Date Name (with appropriate salutation) Organization Address (street) Address (city, state, zip) Dear Name: You have agreed to participate in a research study examining the legislative history of MI PA 61 of 2004, Social Work Licensure. An interview is scheduled for day, date, time, location. This research is being conducted as the dissertation study of Jane Hayes, Ph.D. candidate, under the supervision of Dr. Cynthia J ackson—Elmoore in the School of Social Work, Michigan State University. You are identified by reputation as involved in the policy process or as organizing for the support or opposition of the policy. Your participation will consist of a face-to—face interview of approximately 1 hour in length. Of particular interest are the extent and nature of support for and opposition to social work licensure, as well as, the context in which the legislation was eventually passed. You must be 18-years old to participate in this study. The confidentiality of all participants will be ensured except in those instances when information is already public knowledge or when advance permission is given to attribute a quote. Thank you for you willingness to participate. I look forward to the interview. Sincerely yours, Jane Hayes PhD. Candidate Michigan State University 231-995-3030 hayesel @msu.edu “Ibid. 128 APPENDIX C CASE STUDY OF MI PUBLIC ACT 61 OF 2004 CONSENT FORM 129 CASE STUDY OF MI PUBLIC ACT 61 OF 2004 CONSENT FORM (Adapted with permission from MSU lKB exempt study, X05-986, "State Legislative Histories, Cynthia Jackson-Elmoore, Ph.D.) You are being asked to participate in a research project. I am required to provide a consent form to inform you about the study, to convey that participation is voluntary, to explain the risks and benefits of participation, and to empower you to make an informed decision. You should feel free to ask me any questions you may have. Research Description: You are being asked to participate in a research study examining the legislative history of MI PA 61 Of 2004, Social Work licensure. Of particular interest are the extent and nature of support for and opposition to social work licensure, as well as, the context in which the legislation was eventually passed. You have been identified by reputation as involved in the policy process or as organizing for the support or opposition of the policy. You will not directly benefit from your participation in this study. However, your participation in this study may contribute to a broader understanding of the policy change process through a case study of MI PA 61. There are no foreseeable risks associated with participation in this study. Your participation will consist of a face-to-face interview of approximately 1 hour in length. You must be 18 years or older to participate in this study. The focus of the interview will be your knowledge of and experience with organizations that supported or opposed the legislation. Your participation is voluntary and you may decline to answer any question and end the interview at any time. Permission to hpe/Transcribe: Interviews will be tape-recorded and a transcript made to assist with data analysis. Transcripts will be kept at least 3 years. Data will be stored in a locked file cabinet in the office of the researcher. When all analysis is complete, the transcripts will be destroyed. I agree to allow audiotaping of the interview. Yes No Initials This consent form was approved by the Social Science/Behavioral/Education Institutional Review Board (SIRB) at Michigan State University. Approved 09/18/07 - valid through 06/24/08. This version supersedes all previous versionisB # 07-552. 130 Consent Form (cont.’d) Permission to Use Infogtion from the Interview: The findings of this study will be shared with the secondary researcher’s dissertation committee and other appropriate individuals at Michigan State University. The results may be published or presented at professional meetings. You may request the findings from the secondary researcher. Information will be reported in aggregate form. It may be useful to include quotes; however, it is your decision whether your name appears on any published material. All information will be kept confidential except in those instances when information is already public knowledge or advance permission is given to attribute a quote. If you chose not to give this permission, your privacy will be protected to the maximum extent allowable by law. I agree to allow my identity to be disclosed in reports and presentations. Yes No Initials If you have questions about this study, please contact the primary researcher, Jane Hayes by phone: 231-946-8397, 231-995-3030, or email: Myesel @msu.edu. You may also contact the supervising professor, Dr. Cynthia Jackson-Elmoore by phone: 517-355-2326, email: iagg 174@msu.edu or regular mail at 105 Eustace-Cole Hall, MSU, East Lansing, MI 48824. If you have concerns about your role and rights as a research participant, or would like to register a complaint about this study, you may contact, anonymously if you wish, the Director of MSU's Human Research Protection Programs, Dr. Peter Vasilenko, at 517-355- 2180, FAX 517-432-4503, or e-mail irb@@u.edu, or regular mail at: 202 Olds Hall, MSU, East Lansing, MI 48824. Your signature below means that you voluntarily agree to participate in this research study. Signature and Date This consent form was approved by the Social Science/Behavioral/Education Institutional Review Board (SIRB) at Michigan State University. Approved 09/18/07 - valid through 06/24/08. This version supersedes all previous versrons. IRB # 07-552. 131 APPENDIX D LETTER OF APPROVAL FOR MSU IRB EXEMPT STUDY X05-986 132 LETTER OF APPROVAL FOR MSU IRB EXEMPT STUDY X05-986 MICHIGAN STATE UNIVERSITY Cynthia Jackson-Elmoor‘e, Ph.D. ’ Tel: 517 -432-3739 School of Social Work F ax: 517-353-3038 M2 Baker Hall, East Lansing, MI 48824-1118 June 1, 2006 Jane Hayes Michigan State University School of Social Work East Lansing, MI 48824 Dear Jane: As we have discussed recently, there is preexisting documentation from my MSU IRB exempt study (X05-986) "State Legislative Histories" that may be of use to you in your dissertation research on the policy process and social work licensure. This letter serves as official notification that you have permission to adapt the following items for use in your dissertation research and any related publications: - Participant recruitment letter ° Consent form ' 0 Interview protocol As a condition of this permission, it is expected that appropriate credit will be given for the source of these material, in any and all relevant manuscripts, presentations and/or publications. Sincerely, Cynthia Jackson-Elmore 133 APPENDIX E INTERVIEW PROTOCOL 134 INTERVIEW PROTOCOL Instructions to interviewer: Prior to the interview, obtain permission to record the interview. Introduce yourself, have the interviewee read the cover letter, and obtain informed consent. Ask the interviewee if he or she has any questions about the interview process or the study. Answer all questions as directly as you can without prejudicing the information you may receive. Inform the interviewee that you are going to re-ask permission to record with a tape recorder on so that the interviewee's assent is recorded. Make sure the tape recorder is recording and commence the interview (Grinnell, 2007; O’Sullivan, Rassel & Bemer 2003; Seidman, 1998). 1. Who is your current employer? What is your present position in the organization? What are your responsibilities in the current position? How many years of experience have you had in advocating for public policy? Could you please provide me information about your background and how you became involved in the issues related to licensure of social workers? What organizations did you work for and what interests did they have in social work licensure? How many years of involvement have you had relative to social work licensing? In the 14 years between 1990 and the passage of IVII PA 61, what was your involvement in the issue? What organizations were you a member of that were involved in state licensure of social workers? What positions did you occupy in those organizations? What were your responsibilities? For each organization in which you were involved, please indicate what their position was on state licensure of social workers. Why did they advocate that position? What programs, strategies, lobbying, organizing, or other activities did those organizations engage in relative to licensure? What was your role in each organization relative to the issue of state licensure? What activities were you involved with in relationship to 135 state licensure of social workers? How did these activities influence the efforts relative to social work licensure? 5. Did any of the organizations in which you were involved engage in coalitions or alliances with other organizations? If so, what were they? What was the rationale behind the alliance? What was the influence of the coalition’s efforts relative to State licensure of social workers? How did those relationships change over the 14 years prior to the passage of MI PA 61? 6. What kind of relationships did your or'ganization(s) have with other organizations on the other side of the issue of state licensure of social workers? How did those relationships change over the 14 years prior to the passage of MI PA 61? 7. Given your participation in the issue of state licensure of social workers, what changes did you see in the political context that affected your activities and the efforts of your organizations? DO you think those changes helped or hindered your personal efforts and the actions of the organizations to which you belonged? Why? 8. What do you think were the critical factors in the passage of MI PA 61? What factors do you think might have changed the outcome of passage of MI PA 61? 9. Is there anything else that I should know about efforts to pass or oppose passage of MI PA 61 ? 10. Is there anyone else that I should interview about efforts to pass or oppose passage of MIPA61? 136 APPENDIX F DOCUMENTS 137 DOCUMENTS Author Bergman, D. Bischof, G. Bowden, S. Engler, J. Horwitz, L. Johnson, S. LaVassaur, J. MI-NAS W MI-NAS W Nosel, N. Nosel, N. Nosel, N. Pridnia, J. Speckman-Randall Stankewitz, P. Thompson, Chris Wilbur, K. Organization MI Association of Marriage and Family Therapists MI Association of Marriage and Family Therapists MI Association of BS W Educators Governor of Michigan Economic Alliance of Michigan MI Health and Hospital Association MI Association of Community Mental Health Boards MI -NAS W MI-NAS W United Auto Workers United Auto Workers United Auto Workers MI Senate MI Counties Social Service Association MI Catholic Conference Jackson—Hillsdale Community Mental Health Board Director of Bureau of Occupational and Professional Regulation Date I 2/8/2 003 2/2/2 004 I 2/7/2 003 1 0/1 6/1 99 1 5/1 4/2 003 9/23/2003 9/4/1 992 4/1993 5/25/2000 8/25/2003 1 1/20/200 4 1/20/2004 9/18/1992 1/1/2003 8/21/2007 9/28/1993 7/9/1 992 138 APPENDIX G CODING AGENDA 139 CODING AGENDA Criteria Categories Definition Example Coding Rule Scope of Policy C I .' Advocacy Groups and Statement( s ).' -Support over a Making groups organizations in Support of policy decade or more Community support or Opposition of -Opposition opposition of the policy over a decade policy or more C2: Policy Institutional Statement( s): -Policy monopoly organization(s) with A reference to monopoly that decision making Department of maintains authority regarding Community Health, support for social work Legislature, certification certification. Governor’s ofice versus licensure and other of social organizations work over the representative of I4-year period. the Executive, Legislative, or Judicial branches of government. C3: Other Any individual, Statement“): -Consumers of Stakeholders group, or Self-disclosure of Social Work organizations that is interest and activity Services not an employee of an advocacy group nor a public official (elected, appointed, or employed) Change in C4: Change in Change in Statement(s): -Transfer of the Institutional policy venue institutional A reference to a Board of Social Structure location where change in Work Examiners decisions are made institutional from the related to social arrangements Occupational work licensing Code to the Public Health Code -Transfer of social work regulation from the Department A reference to of Consumer Change in changes in and Industry alignment of alignment of Services to advocacy groups advocacy groups the Department and organizations and organizations of Public Health -A group or organization in support of licensure shifts to join the opposition or vice-verso. 140 Agenda (cont ’d) Critical Events C:5 Mobilization C6: Expansion of policy image C7: Other macro conditions Activity (letters, newsletters, lobbying testifying) of stakeholders to support or oppose licensure Public understanding of social work licensure Social, economic or political conditions Statement(s): Contact with stakeholders Contact with public ojficials Statement(s): Licensing as: -Bureaucracy Expansion -Cost Increase -Job Protection -Public Protection -Restriction of Services -Scope of Practice . . 46 -Title Protection Statement( s ).° -Engler Administration -The election of Jennifer Granholm -Change in public opinion -Any form of contact that demonstrates: behavior to mobilize stakeholders -Behavior to influence policy makers Issue defined as: Bureaucracy Expansion -Cost Increase ~Job Protection -Public Protection -Restriction of Services -Scope of Practice -Last state to . 47 License -Free Market Protection“; Any condition that represents a macro influence 46Title Protection was removed during data collection. The title of “social worker” was protected under the Occupational Code (Michigan Legislature, 1991c, House Bill 4491). 47Last state to license emerged during data collection (in-person, organization in support, November 19, 2007). 8Free market protection emerged during data collection (in person, organization in opposrtion, December 13, 2007). 141 APPENDIX H INTERVIEW CODING PROTOCOL 142 INTERVIEW CODING PROTOCOL Representative Id Group/Organization Id Interview Date Scope of Policy-Making Community l=group/organization 2=public official (elected, appointed, employed) 3=other stakeholders (Any individual or group that is not an employed by an advocacy group nor a public official) 5. Years involved in policy process-MI PA 61 1:0 to 1 2:1 to 3 years 3:4 to 6 years =7 to 10 years 5=10+ 6. Position =support 2=oppose 3=neutral 7. Influence as evidenced by role/responsibilities _years reputation l=extremely weak 2=weak 3=moderate 4=strong 5=extremely strong 8. Change in Institutional Structure O=no l=yes-shift in alignment of groups/organizations =yes-shift in policy venue 3=other 9. Critical Events 0=no 1=Engler Administration 2=Granholm Election 3=Behavior to mobilize stakeholders 4=Other Critical Events 10. Public Image49 1=Bureaucracy Expansion =Cost Increase 3=Job Protection 4=Public Protection 5=Restriction of Services 6=Scope of Practice 7=Free Market Protection 8=Last State to License PENN!" 49Title Protection eliminated and Free Market Protection and the Last state to License added during data collect and analysis. 143 APPENDIX I DOCUMENT CODING PROTOCOL 144 DOCUIVIENT CODING PROTOCOL Document Id _Date Title Publication Author Scope of Policy-Making Community l=group/organization =public official (elected, appointed, employed) 3=other stakeholders (Any individual or group that is not an employed by an advocacy group nor a public official) Years involved in policy process-MI PA 61 1:0 to 1 2:1 to 3 years 3:4 to 6 years 4:7 to 10 years 5=lO+ Position l=support 2=oppose 3=neutral Influence as evidenced by l=extremely weak 2=weak 3=moderate 4=strong 5=extremely strong Change in Institutional Structure 0=no l=yes-shift in alignment of groups/organizations 2=yes-shift in policy venue 3=other Critical Events O=no 1=Engler Administration 2=Granholm Election 3=Behavior to mobilize stakeholders 4=Other Critical Events reputation 12. Public Image 50 1=Bureaucracy Expansion 2=Cost Increase 3:] ob Protection =Public Protection 5=Restriction of Services 6=Scope of Practice 7=Free Market Protection 8=Last State to License SOTitle Protection eliminated and Free Market Protection and Last State to License added during data collection and analysis. 145 APPENDIX J CODE BOOK 146 CODEBOOK . Case ID Rule 1: Refer to Interview Master List . Group/Organization ID Rule 1: Refer to Group/Organization Master List Rule 2: If participant is associated with one or more group/organization, indicate the group/organization the participant represents in his/her support or Opposition of MI PA 61 of 2004. . Interview Date Rule 1: Record the date of interview Rule 2: Record interview as face-to-face or phone . Scope of Policy-Making Community Rule 1: If a case represents a participant employed by an advocacy group or organization in support or opposition and not identified as a public official mark 1. Rule 2: If a case represents a participant in support or opposition as an elected, appointed or employed public official mark 2. Rule 3: If case represents a participant not employed by an advocacy group/organization nor elected, appointed or employed as a public official mark 3. . Years involved in the passage of MI PA 61 of 2004 Rule 1: Indicate the number of years of participation as reported by the participant. . Position Rule 1: Indicate the position of the group/organization as either in support, oppose or neutral as reported by the participant. . Change in institutional structure Rule 1: If the participant makes no reference to a shift in group alignments over the l4-year period nor references a shift in the transfer of the Board of Social Work Examiners from the Occupational Code to the Public Health Code mark 0. Examples of shifts in group alignment: An advocacy group such as the MI Health and Hospital Association who historically opposed licensing not only of social workers but other health professions shifts their position to support MI PA 610f 2004; or, the MI Association of Marriage and Family Therapists shifts from a position of support to oppose MI PA 61 of 2004. Rule 2: If the participant references a shift in group alignments over the 14-year period mark 1. Rule 3: If the participant references the transfer of the Board of Social Work Examiners from the Occupational Code to the Public Health Code mark 2. 147 Codebook (cont.’d) Rule 4: If a participant references a shift in group alignments and a transfer of the Board of Social Work Examiners from the Occupational Code to the Public Health Code mark 3. Rule 5: If the participant references another type of shift or transfer mark 4 and indicate the nature of the shift or transfer. Example: The drafting of new administrative rules regulating the certification of social work under the Occupational Code in 1992. Rule 6: Participant may reference 1 or more changes. 8. Critical Events Rule 1: If the participant references no critical events mark 0. Rule 2: If the participant references the Engler Administration as in opposition to social work licensure mark 1. Rule 3: If the participant references the Granholm as in support of social work licensure mark 2. Rule 4: If the participant references any activity to mobilize stakeholders in support or opposition for the purpose of influencing policy makers mark 3. This activity may include emails, newsletters, list serves, lobbying, testifying, etc. Rule 5: If the participant references other critical event(s) mark 5 and record the critical event referenced by the participant. Examples: Social Summit, NASW Coalition Building, N ASW/Represents the Profession, Legislative Day, BSW Advocacy, Last State to License, Hammerstrom as sponsor, Bi-partisan sponsorship, Leadership of the Executive Director of NASW, Maturation of NASW, Commitment of Governor Granholm, Western Michigan Representatives on the Senate Health Policy Committee, Timing was good. Rule 6: Participate may indicate 1 or more of these critical events. 9. Public Image Rule 1: Participant references the public image of social work licensure as: bureaucracy expansion mark 1; cost increase mark 2; job protection mark 3; public protection mark 4; restriction of services mark 5; scope of practice mark 6;title protection (eliminated); mark 7: free market protection (added) mark 8; last state to license (added). Rule 2: Participant may indicate 1 or more public image(s). 148 APPENDIX K INTERVIEW MATRIX 149 INTERVIEW MATRIX51 ID # CO PE PI PI PP PR PS CG CV CO CE CGr CM 1 X X X X X X X X X 2 X X X X 3 X X X X 4 X X X X X X X X X X 5 X X X X X X 6 X X X X X X X X X 7 X X X X X X X 8 X X X X X X X X 9 X X X X X X X X X 10 X X X X X X X X X 1 l X X X X X X X 12 X X X X X X 13 X X X X X X X 14 X X X 15 X X X X X X 16 X X X X X X X X X 17 X X X X X .18 X X X X X X X 19 X X X 20 X X X X X X X X X 21 X X X X X X X CO=Other Critical Events PE=Public Image/Expansion of Bureaucracy PI=Public Image/Increase Costs PI=Public Image/Job Protection PP=Public Image/Public Protection PR=Public Image/Restriction of Services PS=Public Image/Scope of Practice CG=Shift in Group Alignment CV=Shift in Policy Venue CO=Other shifts CE=Critical Event/Engler Adm CGr=Critical Event/Grandholm Adm CM-Critical Event/Mobilization 5|Interview matrix was used to organize a large amount of data and provided a visual tool for handling the data. Title Protection was removed from the matrix during data analysis. Free Market Protection and Last state to license are not included because they emerged during data collection and analysis. 150 APPENDIX L DOCUMENT MATRIX 151 DOCUMENT MATRIX52 ID# CO PE PI PI PP PR PS CG CV CO CE CGr CM 5 X X X 48 X 50 X X 47 5 3 49 ><><>< 52 X 54 X 10 X 59 X X X 60 61 62 55 67 56 X XX ><><><><>< ><><><><><>< 25 29 X 30 X 33 X X X 32 X 63 X X 45 X 35 X X 37 X 36 X 18 X 19 41 42 X 43 71 X ><><><><>< 52Document matrix was used to organize a large amount of data and provided a visual tool for handling the data. Title Protection was removed from the matrix during data analysis. Free Market Protection and Last state to license are not included because they emerged during data collection and analysis. 152 65 64 7 57 72 66 46 73 74 ><><><>< CO=Other Critical Events PE=Public Image/Expansion of Bureaucracy PI=Public Image/Increase Costs PI=Public Image/Job Protection PP=Public Image/Public Protection PR=Public Image/Restriction of Services PS=Public Image/Scope of Practice CG=Shift in Group Alignment CV=Shift in Policy Venue CO=Other shifts CE=Critical Event/Engler Adm CGr=Critical Event/Granholm Adm CM-Critical Event/Mobilization 153 APPENDIX M MICHIGAN H.B. NO. 5004 OF 1990 154 MICHIGAN H.B. NO. 5004 OF 1990 Short Description: Bill Number: House Sponsors: Synopsis as introduced: House Amendments: Bill Status/Action: Date Chamber 7/1/1989 House 9/20/1989 House 6/1 1/1990 House 6/13/1990 House 6/14/1990 House SOCIAL WORK LICENSURE HB5004 (530517) Representatives Gubow, Stabenow, Leland and Gire Bill proposed to repeal Article 16 of the Occupational Code that regulates social workers and added a new part to the Public Health Code that provided for the licensing of social workers. Defined a single scope of practice for the LBS W and LMS W. Established categories to include: registered social work associate; LBS W; LM S W; and limited license. Established a Board of Social Work. Established standards on confidentiality and professional disclosure. Defined exceptions. Established a scope of practice for the LBS W as distinct and separate from the scope of practice for the LMS W. LMS W included the practice of psychotherapy and advanced social case work practice. Eliminated the category of social work technician. Expanded the Board of Social Work from 5 to 9 members, and elaborated on the standards for confidentiality, disclosure, and exceptions. Action Introduced, first reading and referred to the Committee on Public Health Printed copies filed 8/9/89 Reported with recommendations, S (H-4) Second reading, S( H -4 ) adopted and placed on third reading Third reading, passed with immediate eflect with 95 yeas, 2 nays, title amended and transmitted to the Senate Source: Michigan Legislature (19900, House Bill 5004) 155 APPENDIX N MICHIGAN H.B. NO. 4491 OF 1991 156 MICHIGAN H.B. NO. 4491 OF 1991 Short Description: Bill Number: House Sponsors: Synopsis as introduced: House Amendment: House Bill as passed SOCIAL WORK LICENSURE H8449] ($80354) Representative Gubow Bill proposed changing the regulation of social work from the Occupational Code to the Public Health Code. Scope of practice defined for the LBS W and LMS W. LBS W practice defined as social casework inclusive but not limited to social assessments, planning, and interventions with individuals, families, couples, or groups. LMS W practice inclusive of advanced social case work and psychotherapy. Board could allow the practice of psychotherapy by other licensees under certain conditions. Bill defined the categories of social work as LBS W, LMS W, and limited license. Social work technicians were eliminated under this bill. Bill established a Board of Social Work, set standards for confidentiality and disclosure, and established exceptions. Included in those exceptions were state civil service employees. Reinstated ‘social work technician ’ and defined requirements for registration. Incorporated an affidavit for the LMSW to practice psychotherapy that verified master 's degree, experience in the practice of psychotherapy that included the treatment of mental, emotional and behavioral disorders while practicing as a CS W, specialized course work, and 2-years of supervised practice. Distinguished the scope of practice between the LBS W and LMSW. LMS W able to do counseling and to diagnose emotional and social dysfunctions. Under certain circumstance, ‘clinical social workers’ would be able to practice psychotherapy following the signing of an affidavit. Bill Status/Action: Date Chamber 3/6/1 991 House 3/1 U] 991 House 3/25/1991 House 3/2 7/1 991 House Action Introduced, first reading, referred to the Committee on Public Health Printed copies filed Reported with recommendations S(H-I). Referred for second reading Read a second time. S( H -I ) amended and adopted, placed on third reading, placed on immediate passage, read a third time, postponed temporarily, passed with roll call vote 62 yeas, 39 nays, title amended, transmitted to the Senate. Source: Michigan Legislature (199ld, House Bill 4491) 157 APPENDIX O MICHIGAN S.B. NO. 0617 OF 1993 158 MICHIGAN S.B. NO. 0617 OF 1993 Short Description: Bill Number: Senate Sponsors: Synopsis as introduced: SOCIAL WORK LICENSURE $3061 7 Senators Pridnia, Dillingham, McManus, Jr., Gougeon Emmons, Dunakiss, C isky, Ehlers, Hofl'man, Pollack, Kelly, Kovisto, and O’Brien Bill proposed to transfer the regulation of social workers and marriage and family therapists from the Occupational Code to the Public Health Code. For social work, bill would revise the qualifications to register as a social work tech, social worker, and certified social worker. Bill defined the qualifications for regulation to include educational requirements as well as specified work experience. All work experience to qualify must be attained after the completion of the educational requirements and under the supervision of a certified social worker. Action Introduced and referred to Committee on Health Policy Printed and filed 5/6/1993 Reported favorably without amendment and referred to Committee of the Whole Reported favorably by the Committee of the Whole without amendment and placed on order of third reading Amended, rules suspended, passed with roll call 36 yeas, 0 nays, 2 excused Referred to the House First reading and referred to the Committee on Public Health Bill Status/A ction: Date Chamber 5/5/1993 Senate 5/1 1/1 993 Senate 5/13/1 993 Senate 5719/] 993 Senate 5/25/1 993 Senate (Bill changed Chambers (Senate to House) 5/25/1993 House 5/26/1 993 House Source: Michigan Legislature (1993, Senate Bill 0617) 159 APPENDIX P MICHIGAN H.B. NO. 4813 OF 1995 160 MICHIGAN H.B. NO. 4813 OF 1995 Short Description: SOCIAL WORK LICENSURE Bill Number: HB4813 House Sponsors: Representatives Gubow, Leland and Gire Synopsis as introduced: Transferred the regulation of social workers fiom the Occupational Code to the Public Health Code. Established a Scope of practice for the LBS W and LMS W with the later able to diagnose, counsel or practice psychotherapy. Established categories of social work to include social work technician. To practice psychotherapy, established the afl'idavit requirement and the exception to other licensees to practice psychotherapy if they met the requirements. Established license renewal process and continuing education under the regulation of the rules established by the Board of Social Work. Licensee fees established Exemption of civil service employees. Bill Status/A ction: Date Chamber Action 5/1 0/1995 House Introduced, first reading, referred to Committee on Health Policy 5/16/1995 House Printed and filed upon the members, May 15, I 995 Source: Michigan Legislature (1995, House Bill 4813) 161 APPENDIX Q MICHIGAN H.B. NO. 4274 OF 1997 162 MICHIGAN H.B. NO. 4274 OF 1997 Short Description: Bill Number: House Sponsors: Synopsis as introduced: House Amendments: Senate Amendments: Bill Status/Action: Date Chamber 2/1 1/1997 House 5/26/1998 House 6/23/1 998 House 6/24/1 998 House SOCIAL WORK LICENSURE HB42 74 Representative Gubow Bill as introduced would transfer the regulation of social workers from the Occupational Code to licensure under the Public Health Code. Defined a scope of practice between the LBS W and LMS W and included registered social work technicians. Required the LMS W to file an affidavit for the practice of psychotherapy. The bill proposed the establishment of the Board of Social Work to set standards for confidentiality provide for the limited license and set licensing fees. Exceptions were granted under the bill. Amendment to amend the Public Health Code to provide for the registration and regulation of social work. Tie-barred to House Bill 5736. H.B. 5736 would amend the nonprofit Health Care Corporation Reform Act that regulated Blue Cross and Blue Shield of MI. to specify that health care corporations are not required to provide benefits/reimburse services to an athletic trainer licensed under the Public Health Code. Tie- bar to H.B. 5 736 would amend the nonprofit Health Care Corporation Reform Act that regulates Blue Cross and Blue Shield of MI. to specify that health care corporations are not required to provide benefits/reimburse services performed by a member of a health care profession that was not licensed on or before Jan 1, 1998 but became licensed or registered after Jan 1, 1998. Action Referred to Committee on Health Policy Reported with recommendations S(H-3), referred to third reading S(H-3) adopted, placed on third reading Passed, given immediate efiect: Roll call, 99 yeas, 00 nays, title amended 163 H.B. 4274 (cont’d) Bill Changes Chambers (House to Senate) 6/25/1 998 I 2/8/1 998 12/10/1998 12/10/1 998 12/10/1998 12/22/1 998 12/31/1998 Senate Senate Senate House House House Bill moved to Governor’s Ofiice Governor Referred to Committee on Economic, Development, Intemational Trade, and Regulatory Affairs Reported favorably with S(S-3) and amendments Reported by Committee of the Whole favorably with S(S-3) and amendments. S(S-3) and amendments concurred in, placed on third reading, placed on immediate passage, passed, given immediate effect. Roll call 30 yeas, 5 nays, 0 excused, 3 not voting. Inserted fitll title. Bill Changed Chambers (Senate to House) S( S -3 ) concurred in Roll call, 98 yeas, 0 nays, fitll title agreed to, bill ordered enrolled - Presented to the Governor Engler Vetoed by Governor Engler 1/4/1999 Source: Michigan Legislature (1997, House Bill 4274). Available: http://wwwlegislature.mi.gov. Retrieved April 25, 2008. 164 APPENDIX R MICHIGAN SE. NO. 0657 OF 1999 165 MICHIGAN S.B. NO. 0657 OF 1999 Short Description: Bill Number: Senate Sponsors: Synopsis as introduced: Bill Status/A ction: Date Chamber 6/16/1999 Senate 10/2 7/1999 Senate 1 1/2/1999 Senate SOCIAL WORK LICENSURE S3065 7 Senator Shugars and Leland Bill proposed an amendment of the Public Health Code to provide for the registration and regulation of social work and a repeal of Article 16 of the Occupational Code that regulated social workers. The bill specified application and licensing fees. Bill also established a Board of Social Work. The bill established mandatory academic training for social work to be from an accredited training program, college or University approved by the Board. Social workers registered under the Occupational Code would be registered under the Public Health Code but would be required to renew under the provisions of the Public Health Code. Action Referred to the Committee on Economic, Development, International, and Regulatory Aflairs Reported favorably without amendment Reported by Committee of the Whole favorably without amendment, placed on order of third reading Bill Changed Chambers (Senate to House) 1 1/3/1999 House 1/26/2000 House 2/1/2000 House Referred to Committee on Regulatory Reform Reported with recommendations and amendments, referred to second reading Amended, placed on third reading, placed on immediate passage, passed, given immediate effect, Roll call, 106 yeas, 0 nays. Inserted fitll title, returned to the Senate. Bill Changed Chambers (House to Senate) House inserted full title House requested return Vote on passage reconsidered, motion to refer to third reading reconsidered, returned to second reading, amended, placed on third reading 2/2/2000 Senate Bill Changed Chambers (Senate to House) 2/8/2000 House 2/10/2000 House 2/1 0/2000 House Placed on immediate passage, passed, given immediate effect, 106 yeas, 0 nays, inserted full title, re-retumed to the Senate 166 MI SB. 0657 OF 1999(cont’d) Bill Changed Chambers (House to Senate) 2/15/2000 Senate House inserted full title 2/16/2000 Senate House amendments concurred in. Roll call, 36 yeas, I nays, I excused. Given immediate effect, full title agreed to, ordered enrollment Bill sent to Governor’s Office 2/23/2000 Governor Presented to the Governor 3/8/2000 Governor Approved by the Governor, filed with the Secretary of State as PA 0011 ‘00 Source: Michigan Legislature (1999, Senate Bill O657).Available: httlLJ/www.legislature.mi.gov. Retrieved April 25, 2008. 167 APPENDIX S GROUPS, ORGANIZATIONS, AND PUBLIC OFFICIALS IN SUPPORT AND OPPOSITION OF SOCIAL WORK LICENSURE 168 GROUPS, ORGANIZATIONS, AND PUBLIC OFFICIALS IN SUPPORT AND OPPOSITION OF SOCIAL WORK LICENSURE MI-National Association of Social Workers is a membership organization of professional social workers throughout the state of Michigan. The organization works to enhance the professional growth and development of its members, creates and promotes standards of professional practice, and advocates for sound and fair social welfare policies.53 MI Association of Bachelor of Social Work Educators is a membership organization of social work faculty who work with BSW programs in Michigan’s universities and colleges. The organization represents 22 (19 at the time of licensure) programs and advances the interests of the BSW programs and their graduates (in-person interview, organization in support, December 3, 2007). MT Association of School Social Workers is a membership organization of professional social workers employed in a school setting. The mission of the organization is to strengthen school social work services to meet the needs of children. MASSW promotes the professional development of its members through conferences and workshops, maintains standards of school social work practice and advocates for policies responsive to the needs of children.54 MI Schools of Social Work, Michigan universities and colleges include 22 Bachelor of Social Work programs and 7 Master of Social Work Programs. Programs are accredited by the Council on Social Work Education.55 53NASW. Available: http://www.socialworkers.org/nasw/defaultasp. Retrieved May 5, 2008. 54MAssw. Available: http://www.massw-mi.org/. Retrieved May 5, 2008. 55CSWE. Membership. Available: http://wwwcsweorg. Retrieved May 5, 2008. 169 Prggram Program Level Accreditation Status Adrian College Baccalaureate Candidacy Andrews University Baccalaureate Accredited Andrews University Masters Accredited Calvin College Baccalaureate Accredited Central Michigan University Baccalaureate Accredited Cornerstone University Baccalaureate Accredited Eastern Michigan University Baccalaureate Accredited Eastern Michigan University Masters Accredited Ferris State University Baccalaureate Accredited Grand Valley State Baccalaureate Accredited University Grand Valley State Masters Accredited University Hope College Baccalaureate Accredited Kuyper College Baccalaureate Accredited Madonna University Baccalaureate Accredited Marygrove College Baccalaureate Accredited Michigan State University Baccalaureate Accredited Michigan State University Masters Accredited Northern Michigan Baccalaureate Accredited University Oakland University Baccalaureate Candidacy Saginaw Valley State Baccalaureate Accredited University Sienna Heights University Baccalaureate Accredited Spring Arbor University Baccalaureate Accredited University of Detroit Mercy Baccalaureate Accredited University of Michigan Masters Accredited University of M ichigan-F 1 int Baccalaureate Accredited Wayne State University Baccalaureate Accredited Wayne State University Masters Accredited Western Michigan University Baccalaureate Accredited Western Michigan University Masters Accredited Source: CSWE. Membership. Available: http://www.cswe.org. Retrieved May 5, 2008. Capitol Services, Inc. is a multi-client lobbying firm. The organization “works with nonprofit groups and association on governmental policy issues.” Capitol Services continues to maintain a contractual relationship with MI-NASW (in-person interview, organization in support, September 10, 2007). MI Psychiatric Association is a district branch of the American Psychiatric Association. It is a membership organization of physicians who specialize in the 170 diagnosis, treatment and prevention of mental illness, including substance abuse. The organization advocates for the funding and operation of programs to service the mentally ill and programs to educate the public on mental illness.56 MI Psychological Association is an affiliate organization of the American Psychological Association. It is a membership organization of approximately 1,000 psychologists. The purpose of the organization is to advance psychology as a profession and set standards of professional practice. The organization also participates in the public policy process on behalf of the profession and its membership.57 MI Health and Hospital Association is an organization of hospitals, health systems and other organizations involved in health care. The Association represents the groups at the regional, state and national level before the legislature, regulatory agencies and the media.58 MI Association of Community Mental Health Boards is a membership organization open to the 46 Community Mental Health Service Providers over 83 counties in Michigan. The Association supports the community mental health service providers through the development and promotion of effective relationships between the service providers, Governor, Legislature, and advocacy groups. It also represents the interests of the community health providers with the public and explores problems of common interest.59 56MI Psychiatric Association. Available: http://www.mpsonline.orglhtml@bout mpshtml. Retrieved May 5, 2008. 57M1 Psychological Association. Available: http://wwwmichpsych.org/index.cfm?location=l. Retrieved May 5, 2008. 58MHA. Available: http://www.inhfiacrg/mha app/public site/Lbout us.isp. Retrieved May 5, 2008. 59MIACMHB. Available: baby/WWW.macmhbbrg/backgioundbtm. Retrieved May 5,2008. 171 AuSable Community Mental Health is the community mental health service provider for three Michigan counties—Iosco, Ogemaw and Oscoda. AuSable CMH is responsible for the planning, monitoring and implementing of mental health programs for persons with mental illness and developmental disabilities within in its geographic area of Michigan.60 MI Federation for Children and Families is a membership organization of private, nonprofit human service providers and other advocates and consumers. The organization promotes the work of the private nonprofit to provide effective and efficient services to children and families. The organization also works to influence sound public policy as it relates to the needs of children and families.61 MI Catholic Conference is an organization that represents the Catholic Church in Michigan on matters of public policy. The organization’s purpose is to improve the lives of people through sound public policy.62 MI County Social Services Association is a statewide organization composed of Department of Human Services’ board members, directors, district managers, and supervisors that represent all 83 counties in Michigan. The organization advocates on social service issues that impact Department of Human Services’ clientele."3 60AuSable CMH. Available: http://www.macmhb.org/directory07-08.wpd.pdf. Retrieved May 5, 2008. 61M1 Federation for Children and Families. Available: http://www.michfed.org/federation. Retrieved May 5, 2008. 62 MI Catholic Conference. Available: http://www.micatholicconferenceorg/genegl info. Retrieved May 5, 2008. 63MI County Social Services Association. Available: http://www.mcssa.com. Retrieved May 5, 2008. 172 MI Association of Counties is a membership organization for all 83 Michigan counties. The organization advocates for the interests of county governments. MAC offers educational programs and legislative representation to its membership.64 MI Department of Community Health/Granholm Administration is one of 20 state departments and the largest of them. The agency employs approximately 4,300 individuals with a gross appropriation of 11.2 billion dollars. The Department of Community Health is responsible for the planning of health policy and the management of a publicly funded health system that serves approximately 2 million Michigan residents.65 MI Department of Consumer and Industry Services is now known as the Department of Labor and Economic Growth. The Licensing Division of the Department oversees the regulation of 26 different commercial occupations. It maintains the public records for business organizations, issues licenses and conducts investigations.“ MI Board of Social Work is a publicly appointed board that is charged to promote and protect the health, safety and welfare of the public. Under MI PA 368 of 1978, the board has the authority to establish minimal entry level competency of social workers and an obligation to take disciplinary action against those who harm the public’s health, safety and welfare. The board is composed of 9 voting members, 6 social workers and 3 public representatives. The board oversees the regulation of 1,753 registered social 64MAC. Available: http://www.micounties.org/AboutMAC/tabid/S7/Default.2_lspx. Retrieved May 5, 2008. 65Department of Mental Health. Available: http://wwwmichigan .gov/mdch. Retrieved May 5, 2008. “Department of Labor and Economic Growth. Available: http://wwwmichigan.gov/dlegZO,1607,7-154-28077---,00.html. Retrieved May 15, 2008. 173 service technicians, 6,511 licensed bachelor social workers and 14,256 licensed master social workers.67 House Republican Policy Office is the organization within the legislature that houses the policy analysts. These policy analysts “write laws, identify polices to be pursued, analyze proposed legislation and provide support to members of the [Republican House] as far as answering constituents questions and questions [the legislators] might have on legislation” (in-person interview, organization in support, December 13, 2007). Representative David Gubow was a Democratic House Representative from 1985 through 1998. Representative Gubow represented District 67 from 1985 to 1994 and District 35 from 1995 to 1998. Gubow was the primary sponsor of: H.B. 5004 of 1990; H.B. 4491 of 1991; H.B. 4813 of 1995; and, H.B. 4274 of 1997 (Michigan Library, personal communication, May 5, 2008).68 Senator John Pridnia was a Republican member of both the Michigan House and Senate. He was first elected to the House in 1982 and served until 1990 representing District 106. He was a state senator from 1991 to 1994 representing District 36. Senator Pridnia was the primary sponsor of SB. 617 of 1993 (Michigan Library, personal communication, May 5, 2008).69 Senator Dale Shugars was a Republican member of the Michigan Senate from 1998 to 2006 representing the 21St District. Prior to his election to the Senate, he served in 67MI Board of Social Work. Available: http://wwwmichigan.gov/mdch/O,1607,7-l32- 27417 27529+27554-70397--,00.html. Retrieved May 5,2008. 68Email communication. 69 . Ibld. 174 the MI House. Senator Shugars was the primary sponsor of SB. 657 of 1999 (Michigan Library, personal communication, May 5, 2008).70 Representative Stephen R. Ehardt was a Republican member of the Michigan House who represented the 83rd District from 1999-2004. Representative Ehardt was the Chair of the House Health Policy Committee when S. B. 189 of 2003 was introduced.71 The Michigan House Health Policy Committee was a standing committee of the Michigan Legislature to which SB. 189 of 2003 was referred for discussion, analysis and revisions (Michigan Legislature, 2007-2008). Members of the Health Policy Committee included Representatives Ehardt (Chair), Vander Veen, Gaffney, Hart, Hune, Rocca, Van Regenmorter, Ward, Woronchak, Adamini (Vice-Chair), Clack, Gillard, Hardman, O’Neil, and Wojno.72 Senator Beverly Hammerstrom at the time of the passage of SB. 189 of 2003 was a Republican state Senator representing the 17th District in Michigan. Senator Hammerstrom was the Senate Majority Floor Leader, Chair of the Senate Health Policy Committee, and Vice-Chair of both the Families and Human Services Committee and Government Operations Committee. Prior to her election to the Senate in 1998, Senator Hammerstrom was the House representative from the 55th District from 1993 through 1998. Senator Hammerstrom was the primary sponsor of SB. 189 of 2003.73 70Ibid. 71Michigan Manual (2003-2004). Available: httg/lwww. leggature.rrri.gov/documentslpublications_/rn_anual/2005 -2006/2005 -MM-0297-030 l - Formerpdf. Retrieved May 19, 2008. 72Michigan Manual (2003-2004). Available: httpzl/www.legislature.mi.gov/(S(3rgOnr552vhuk145xa5clip45))/documents_/publications/manual/ 2003-2004/2003-mm—0157-0161-RepLists.pdf. Retrieved May 19, 2007. 73Senator Beverly Hammerstrom. Available: httpzl/www.utoledo.edu/as/alumni/2005.html. Retrieved May 5, 2008. 175 The Michigan Senate Health Policy Committee was a standing committee of the Michigan Legislature to which SB. 189 of 2003 was referred for discussion, analysis and revisions (Michigan Legislature, 2007-2008). The Senate Health Policy included Senators Hammerstrom (Chair), Patterson (Vice-Chair), George, Bemero (Vice-Chair), and Jacobs.74 Governor Jennifer Granholm is the current Democratic Governor of Michigan succeeding Republican Governor John Engler. The Governor is serving her 2Ind and final term due to term limits. She is also a former Attorney General for the State of Michigan (1998-2002).75 United Auto Workers is an international union that represents employees of the state of Michigan. UAW Local 6000 represents human services and administrative support units composed of 22,000 employees in 1200 worksites. Approximately 10,000 of these members are employees of the Department of Human Services (in-person interview, organization in opposition, September 21, 2007). M1 Association of Marriage and Family Therapists is a division of the American Association of Marriage and Family Therapist. The AAMFT is a professional membership organization that includes a membership of 24,000 marriage and family therapists in the United States and Canada. The purpose of the organization is to promote and advance the common professional interests of marriage and family therapists.76 74Michigan Manual (2003-2004). Available: imd/www.legislaturemi.gov/(S(3rg0nr552vhukl45anqi945))/documentypublications/manual/ 2003-2004/2003-mm-0115-0117-SenLists.pdf Retrieved May 19, 2007. 75Governor Jennifer Granholm. Available: may/www.micbigangov/aov/o,1607,7-168--57920-- 00.html. Retrieved May 5, 2008. 76MAMFr. Available: httpzllwww.michiganfamilytherapy.orgfabout%20mft.htm. Retrieved May 5, 2008. 176 Economic Alliance of Michigan is a membership organization composed of business and labor unions. Their purpose is to provide a forum for cooperative endeavors between the two groups in order to promote a healthy Michigan business environment.77 MI Association of Mental Health Counselors is the state chapter of the American Mental Health Counselors as well as an independently operating division of the MI Counseling Association. The organization is a membership organization that promotes ethical standards of practice, professional development and advocates for the profession in areas of public policy.78 MI Association for Adult Development and Aging is a division of the MI Counseling Association. The organization acts as a network for counselors interested in professional development related to adult development and aging issues.79 MI Association of Humanistic Education is a membership organization and a division of the MI Counseling Association. The organization promotes humanistic principles in learning and research.80 The Bureau of Occupational and Professional Regulation in the Department of Commerce/Engler Administration administered the registration process for social workers and other occupations and professions. The Bureau’s mission was to protect the health, safety and welfare of Michigan consumers.81 77Economic Alliance of MI. Available: http://www.eamonline.org. Retrieved May 5, 2008. 78M1 Counseling Association. Available: http://www.mm_hca.org. Retrieved May 5, 2008. 79M1 Association for Adult Development and Aging. Available: http://www_aadaweb.org. Retrieved May 5, 2008. 80M1 Association of Humanistic Educators. Available: httpzllwww.michigancounselingassociationcom. Retrieved May 5, 2008. 81Bureau of Occupational and Professional Regulation. Available: httpzllauchen.michigangov/digests/96_97/6340295.htm. Retrieved May 26, 2008. 177 Department of Community Health/Engler Administration was the outcome of a consolidation of the Department of Public Health, Department of Mental Health and the Medical Services Administration (Medicaid) that took place in 1996. The Office of Drug Control Policy and the Office of Services to the Aging were also located in the Department. The Department gross appropriation was approximately 10 billion dollars under the Engler Administration. The Department of Community Health was responsible for the planning of health policy and the management of a publicly funded health system (in-person interview, organization in opposition, November 2, 2007). Governor John Engler was the Republican Governor of Michigan who preceded Governor Granholm. Governor Engler was first elected in 1990. Prior to his election as Governor, he served in the Michigan Senate beginning in 1979. In the Senate, he served as Senate Majority Leader from 1985 until his election as Governor. 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